BUIES CREEK, North Carolina – Dr. Brian Forrest, founder of Access Healthcare Direct of Apex, North Carolina, presented “Direct Primary Care: Ethically Meeting the Quadruple Aim” at the second Grand Rounds for the 2016-2017 academic year today at CUSOM.
Dr. Forrest shared with students, faculty and staff his development of a Direct Primary Care (DPC) practice where patients pay a flat fee to be a patient under the care of the practice. According to Dr. Forrest, approximately 4,000 DPCs opened nationally in the past year and most of the patients seen in DPC practice had cheaper out of pocket costs – insured and uninsured patients alike.
“Direct Primary Care is relationship based,” said Dr. Forrest. “And the economic benefits of the DPC physician-patient relationship are 92 percent less readmission rates and 65 percent less ER visits.”
Dr. Forrest not only has his own DPC practice in Apex, but Access Healthcare Direct is a national network of DPC practices, and he has helped physicians around the country to transition to new models and is currently helping physicians in direct care practices in over 24 states. Physicians are drawn to this practice model because of the quadruple aim says Dr. Forrest –“increased quality of and access to care and improved costs and experience for both the physician and the patient.”
In describing how the physician-patient relationship works in a DPC practice, Dr. Forrest gave an example of diagnosing a patient via a HIPPA compliant teleconference and the cost to the patient for this “office visit” is zero other than their regular monthly fee that ranges from $45 to $59 per month or $500 annually. He has not billed to an insurance company in fifteen years.
“If I’m making enough money, why do I need to nickel and dime my patients?”
Whether a patient is Medicaid, Medicare, insured or uninsured, in the DPC model they pay a flat fee for primary care and have increased facetime with their physician. According to a study Dr. Forrest presented – DPC patients see their physician annually for an average of 140 minutes versus patients in a traditional practice model seeing their physician for an average of 20 minutes.
The DPC model has even been adopted by the state of Washington’s Medicaid plan. But, Dr. Forrest does not spare his audience the truth that transforming from a traditional primary care practice model to DPC is a major disruption and even starting from scratch is challenging in our co-pay culture.
“Typically, you will lose 35 percent of your patients during the transition to DPC,” said Dr. Forrest. “But, typical recovery takes about a year.”
“Dr. Forrest indirectly illustrated how much further we still need to go,” said first year medical student TJ Escalante. “The difficulties that his practice doesn’t have to deal with, from a stand-point of insurance, still affects those individuals that need to seek medical treatment from a specialist and furthermore from any level of emergency medicine.”
Despite these challenges of the DPC model, the medical students were inspired.
“Dr. Forrest was a great speaker,” said first year medical student Chris Ferrante. “His passion for changing the primary care landscape is inspiring, and gives hope to all future physicians that want to go into family medicine.”
First year medical student, John Manor agreed.
“Today’s Grand Rounds presentation on Direct Primary Care was a wonderful exploration of a greatly simplified system of healthcare that is 100% patient focused and has the potential for increased revenue and quality of life for family physicians.