The Concierge and Direct Primary Care Models Research Paper

Introduction

The rapid evolution in the healthcare system is making physicians face significant challenges that affect their service provision to patients. There are several healthcare models that offer varying subscription fees to facilitate the process of care delivery. The variation in payment has resulted in a reduction in revenue and an increase in expenses leaving the providers with limited income. The aspect is making the clinicians have a decline in their salaries. There are a number of reforms established by the clinics to ensure they obtain payment from uninsured patients and further collect differences from insured persons. Despite the challenges, the Concierge and Direct Primary Care (DPC) models have proven to be a promising approach that will enable doctors to have sufficient revenues to facilitate activities. The two models provide distinct solutions thus it is necessary for the healthcare provider to properly understand each before choosing one of them.

The Concept of Concierge and DPC Models

The concierge medicine model entails direct access to the primary care provider. In this approach, the focus is on improving the patient experience by allowing the client to have the ability to reach the physician whenever the need arises. In most cases, the patient may opt to use telephone, direct appointments, or emails accompanied by individualized in-depth care within the same day. The approach and the freedom to access medical services make the concierge health model more expensive (Charrow et al., 2021). Even though it is costly, the concierge facilitates intimate encounters between the patient and the respective doctor thus making the individual realize satisfaction. It enhances and strengthens the connection among the people using the model.

The DPC model on the other hand refers to the effective financial agreement between the patient and their respective healthcare provider. The DPC does not involve or accept insurance coverage; however, the patients have the freedom to enroll in health plans which are highly deductible. Since DPC does not allow the aspect of insurance, the monthly fee is approximately $100 and above. It gives the clients effective alternatives to insurance billings which include monthly, quarterly, or annual subscriptions. Even though DPC charges are high, once patients have enrolled they are entitled to various services including preventive care, care coordination and lab tests (De Santiago et al., 2021). The model considers factors such as age, type of practice, and family size on the plan to determine the amount of fee to be charged. Once the payments are made, the patient has an unlimited right to meet the doctor anytime. Furthermore, the approach promotes personalized and individualized care services making it easier for the clinician and the client to reduce possible stress.

Advantages of Moving Primary Care Physicians to Concierge Model

Rewarding Medicine Practice

Generally, physicians, experience a high rate of burnout following the commitment to proving necessary care services to their patients. Therefore, by switching to concierge medicine, practitioners will be able to deal with specific clients thus reducing the workload (Claytor, 2020). In addition, the health model allows patients to take responsibility for their health and pay a membership fee which is then used by the physicians to expand their practices as well as increase their salaries. Furthermore, with the money raised from the subscription, clinicians may opt to reinvest and advance the practices to effectively accommodate patients having limited schedules and need frequent monitoring.

Enhancing Proper Physician-Patient Relationship

The concierge medicine model allows primary care providers to interact with and know their patients effectively. The relationship is vital in influencing patient satisfaction and care outcomes. When sick individuals have access to personal doctors they trust, the likelihood of their health improving is high thus prolonging their lives. The aspect is facilitated following the ease of the patient to communicate and share challenges freely leading to proper care delivery.

Facilitate the Provision of Better Patient Care

In most cases, primary caregivers prefer offering patient-centered services to their clients to improve care outcomes. The concierge medicine approach allows the patients to experience practices based on their own terms. In other words, the approach enables doctors to give adequate attention to sick individuals thus influencing positive and quality care services (Serna, 2019). The model eliminates the aspect of paperwork thus making it easier for physicians to concentrate on offering better services to patients.

Limitations of Moving to the Concierge Medicine Model

Encountering Demanding Patients

Once the patient has paid the concierge fee, they have the authority to demand services. The subscription may give families the chance to dictate how their primary care providers offer them the needed services. Such encounters might make the physicians less productive and discouraged to provide quality care for the respective patient. Furthermore, such behaviors have the potential to reduce the relationship between the patient and the practitioner thus affecting overall patient satisfaction.

Probable Pricing Error

The concierge medicine approach is not common and setting a standard price to cover the patient’s needs might be a challenge. Physicians might add inadequate fees thus making the services to be unprofitable to the healthcare organization. Similarly, charging high prices can prompt the community and other potential patients to seek such services from other providers in the industry. Therefore, the inability to develop a standardized charge makes switching to the concierge model a challenge.

Benefits General Medical Clinic (GMC) will Gain Upon Moving to DPC Model

Improve Care Outcome

By switching primary care providers to the DPC model, GMC will be able to offer effective services to their patients following the close interaction between the sick individual and the respective physician. The approach will make it easier for the providers to provide one-on-one services thus making sure the patients are satisfied with the care provided. In addition, after paying the required fee, patients will have the ability to reach different practitioners of their choice.

Generate Revenue

If GMC opts to move its primary care physicians to the DPC model, it will increase the number of members in the organization. As many patients subscribe to the services, the clinic will be able to generate more income and thus can manage to pay the practitioners effectively and retain their services (Claytor, 2020). When health workers are paid accordingly, they will feel motivated hence enabling GMC to deliver the best care services to the patients.

Demerits Associated with GMC’s Move to DPC Model

Despite the benefits associated with moving physicians to the DPC model, the approach has several limitations that render it ineffective. For instance, opting to provide DPC services will imply that the source of revenue for the facility will be only the patients’ fees (Husain, 2021). Similarly, GMC will not generate income from insurance companies since the practice does not accept such services. In addition, it is difficult to establish an appropriate price hence likelihood of overcharging or undercharging is high.

How Moving to either Model will Change GMC Business Model

Since either of the models is more concerned with patient satisfaction, GMC’s move to DPC or concierge will prompt the healthcare provider to change its service provision accordingly to enable it to meet the needs of the patients who have paid membership fees. By taking such direction, GMC value will increase significantly because the payment made by the patients will be utilized to improve its operations. However, the change in value will be more pronounced under the DPC model because GMC will receive an increased amount of money to cater to patient services. In the concierge approach, GMC will consider the insurance contribution which will have an impact on the money paid to the organization thus reducing the value generated.

Similarly, GMC will have an increase in inputs following adequate income from the patients to finance its operations. Furthermore, because patients will have paid for the services, they will require GMC to have proper tools that improve care services. On the issues of processes, GMC will have limited involvement since physicians will be dealing directly with the patients leading to low paperwork with third parties such as insurance firms. Moreover, GMC revenue will increase as opposed to the current status of the clinic.

Conclusion

Based on the current situation and direction of GMC which include flat salaries for physicians, and increasing expenses, I would recommend GMC switch to the DPC model. The approach will enable the organization to raise more revenue from the monthly fee that patients will pay. Furthermore, DPC will not allow the clinic to engage in insurance processes hence lowering the paperwork that can cause burnout to the practitioners.

References

Charrow, A., Kwak, R., & Nambudiri, V. E. (2021). Dermatoethics: The Ethics of Concierge Medicine. In L. Bercovitch et al. (Eds.), Dermatoethics (pp. 341-347). Springer, Cham. Web.

Claytor, A. R. (2020). Investigating benefits of medical practice model and retention of primary care physicians: An Exploratory Study. AT Still University of Health Sciences. Web.

De Santiago, A., Bingham, J. M., Vaffis, S., Scovis, N., McGlamery, E., Boesen, K., Warholak, T., & Dhatt, H. (2021). Evaluating the role and value of a clinical pharmacist in a concierge primary care clinic. Journal of the American Pharmacists Association, 61(3), 240-247.

Husain, S. A. (2021). Choosing a career in direct primary care. In P. M, Garrett & K. Yooh-Flannery (Eds.), A Pediatrician’s Path (pp. 139-146). Springer, Cham. Web.

Serna, D. C. (2019). Lifestyle medicine in a concierge practice: My journey. American Journal of Lifestyle Medicine, 13(4), 367-370. Web.