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A Doctor’s Guide to a Good Appointment, photo credit New York Times

The New York Times published an interesting article by Dr. Danielle Ofri entitled “A Doctor’s Guide to a Good Appointment

It highlights some practical steps patients can take to choose a good physician and receive quality medical care.   The author lays out several factors to consider.

“Choosing your doctor is the first step.”

In discussing how to pick out a doctor for your medical needs the author points out that deciding on a blender might be easier.  She notes one should check the online reviews on local physicians and then ‘you should also check with your insurance company’.

It really is a sad state of affairs if the best sources of figuring out to whom to trust your life are both overtly biased options.  Online reviews try to gain web-space dominance, and therefore advertising opportunities, by maximizing search engine results but generally are populated with inaccurate and misleading information concerning the physicians they profile.  None of the information on these sites are fact-checked by the companies unless individual physicians take it upon themselves to correct the errors.  So what’s the next option?  Check with the insurance company?  That seems backwards.  Aren’t doctors supposed to work for patients not for insurance companies?

The best option, the author points out is to look for a physician that displays the following characteristics:

  • A doctor who takes his or her time talking with you, as opposed to making you feel like you’re at a drive-through fast-food joint. 
  • A doctor who engages his or her patients in decision-making, as opposed to simply rattling off a to-do list. 
  • A doctor who you can get in touch with on the phone or through secure email.

These are exactly the qualities that a DPC program promotes for physicians.  We allow for 30 to 60 minute visits so that we have plenty of time to hear your story and engage you in decision making.  We don’t want your visits to be an eight minute whirlwind visit.  All DPC members have the option to contact us by phone or email during the business day.  In fact, I just got off the phone with a patient who had influenza but developed new symptoms of concern.  We managed the concern over the phone and saved them a trip to the office.

“How big a practice?”

The author argues that the size of the practice matters less than the doctor you choose.  I would agree with this.  However, she gets the next statement very wrong.

“Another option these days — though much more expensive — is the “direct primary care” model (sometimes known as “concierge” medicine).”

She made a common mistake whereby she confused direct primary care and concierge medicine.  While no absolute definition exists for concierge medicine, it has come to mean a practice or doctor who takes a limited number of patients, generally less than 300, and who charges a retainer fee in addition to billing the patient’s insurance.  In contrast, many states have codified exactly what direct primary care means.  Tennessee did this in 2016 with the ‘Healthcare Empowerment Act’.  DPC practices also are smaller than standard practices at around 600-1000 patients per physician.  They  only accept payment for services from their members and do not bill any third party payers such as insurance companies.  Therefore, our pricing is much lower and it includes a host of services that would otherwise each cost extra.  Memberships in our practice are tiered based on age and start at less than $1 per day for children.

“How much will it cost?”

Cost is a big factor for most families especially if they’ve already spent $15-20k on insurance premiums for the year.  Who wants to spend more?  Unfortunately, many patients have large deductibles that make them responsible for paying for the first $4000-$5000 of medical care before insurance kicks in.  The cost of needed care is generally not known prior to the office visit.  That’s like going to the grocery store, buying food, and then waiting for your bank statement to see what it cost you.  It’s utterly ridiculous.

At Trinity DPC we offer everything on a clear up front pricing agreement.  Most all of our services are available as part of membership so most of our patients don’t have any extra costs for healthcare each month.  Everything else is clearly priced before the service is rendered.  Check out our price transparency page for a list of all our prices on labs and medications. 

“Timing”

“Be prepared that doctors often run behind,” the author writes.  Sad but true.  Lots of things happen that put us behind.  Sick people often need lots of care, however, at Trinity DPC we offer 30 to 60 minute visits in order to better accommodate your needs.  We don’t want to be in a rush when we’re working for you.  I personally feel I can do a better job when I can dedicate all my focus to you and your issues.  After two years of direct primary care practice I can say that our waiting room furniture still looks brand new.  It hardly gets used.

So overall, this article highlights some very practical advice for patients needing to get the most out of our current medical system.  While it mischaracterizes direct primary care as a high priced option (when in reality is a much lower priced option), it misses the obvious conclusion.  Direct primary care, while saving patients out of pocket costs for primary care regardless of insurance coverage, solves all the problems of obtaining quality, personal care illustrated by the author.  Direct Primary Care might be the solution to declining access to proper, affordable medical care.

Consider how a membership with Trinity Direct Primary Care would benefit you and your family.  We operate the largest DPC program in East Tennessee with two offices in Maryville and Hardin Valley.  All our contracts are month to month with no long term commitments.  The registration fee and first month membership often are less than a single visit to an urgent treatment center.  More time with a doctor you trust and with whom you can communicate directly give you the opportunity for your concerns to finally be heard.  Call today at 865-244-1800 to find out more or sign up online to get started.

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