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Making the Case for Direct Primary Care: Page 2 of 2

Making the Case for Direct Primary Care: Page 2 of 2

Licensees of MedLion's model don't have to worry about finding and implementing technology on their own. The company advises doctors on an EHR product that is customized to DPC care, although doctors are independent and physicians can use whatever product they choose, Qamar says. More than all of that though, the doctors' biggest advantage is they remain independent, says Qamar. He considers MedLion as a supplementary service to help the independent doctor's practice grow.

Advantages and disadvantages

Beyond his own model, Qamar sees a lot of advantages in the DPC model of care, especially when compared to fee for service. "For doctors, you don't have to code, you don't have to file claims. It's a huge advantage because you don’t have to rely on a system that has nothing to do with medical practice … Number two, you no longer have to see X number of patients per hour … Third, there is less paperwork and overhead for the practice," he says.

For patients, there are advantages in that DPC can lead to better and expanded access — through next-day appointments and telemedicine. "If a doctor is seeing 30 to 40 patients per day [under fee for service], patients become a number, rather than a human being. Doctors don't like it and patients don't like it," Qamar says.

The biggest challenge as a DPC doctor is changing the culture around U.S. healthcare, he says. The system has been entrenched in fee-for-service medicine for the last 50 years. It's hard for some people to separate primary care from health insurance. "Many of us have been born into a country where we think health insurance means healthcare. Health insurance is not in the business of healthcare, it's in the business of insurance," Qamar says. He says if people used their car insurance for everything, such as windshield wiper fluid, premiums would go up. "That's what you see in healthcare."

Yet, it's a hard sell to individual patients. This is why his model pairs with lean insurance plans and markets to employers. However, this model means in some fashion, MedLion has to operate under the same principles as an insurance company. Thus, it's not easy to sell to employers either. "When are you catering to employers, your competition is the insurance industry," says Qamar. Selling is also hard because of the long sales cycles of employers, he says.

These challenges are one reason why Qamar says he tells new DPC doctors to accept primary-care insurance in the beginning, then grow DPC within. Despite this, he is bullish on the future of DPC. "Direct primary care is one of those unique models where the doctors are back in control and they are back in control with their patients — the only two characters needed in a healthcare scene," Qamar says. "Changing the healthcare [system] won't be easy, it will require a collective effort and the courage to go out there and do your own thing, to not have to rely on insurance companies to give medical care to your patients."

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