Our rapidly changing healthcare environment has both doctors and patients thinking outside of the box. For example, an emerging trend in family medicine is something known as direct primary care (DPC). This new model of primary care encourages doctors to look at family medicine in a whole new way. Some are even combining it with locum tenens work to create a vastly different kind of career.
DPC is a model for offering primary care outside of the constraints of standard health insurance. Patients enter into agreements with their doctors, paying a flat monthly fee in exchange for as much primary care as they need. Think of it as primary care on a subscription service.
Note that DPC is not the same thing as concierge medicine. As stated, the former is more like a subscription service. The latter charges an annual fee in exchange for the right to see the doctor at any time. The two models are similar, but DPC is recognized under the Affordable Care Act (ACA) as an approved way to access primary care without having to purchase insurance.
More Time for Patients
Doctors offering family medicine under the DPC model say that one of the things they most like about it is the ability to spend more time with patients. Because they are not constrained by insurance company mandates or quotas, they can truly concentrate on patient need without having to force visits into a defined amount of time.
The DPC model also allows doctors to offer affordable primary care to more people. Unlike concierge medicine, which tends to be cost prohibitive for lower income families, DPC rates tend to be more in line with middle-class incomes. Family doctors are better able to serve less affluent patients under this model.
Combining DPC with Locum Tenens
Family medicine offered under the DPC model is similar to private practice in that the doctor is a self-employed business owner. An added benefit of being self-employed is that it allows the doctor to take locum tenens assignments without having to establish a separate business entity. Many new DPC physicians do just that in order to keep their incomes steady while they build their practices.
One particular doctor who wrote a piece for AAFP this past summer (2018) talked about how combining DCP with locum tenens provided him a bit of balance. He sees regular patients in his urban office during the week, then takes locum shifts a couple of weekends per month. His locum assignments tend to be in rural areas in Missouri, Kansas, and Colorado.
Taking locum shifts in rural areas gives this family doctor the opportunity to experience an entirely different environment of care. Outside of the busyness of an urban office, he’s able to treat his rural patients in ways that are more closely aligned with their circumstances and way of life.
Family Medicine Is Changing
Acknowledging both direct primary care and the ever-growing need for locums is also to acknowledge that family medicine is changing. The way primary care was offered just a few decades ago is a quickly dying model in the US. Whether that’s good or bad is up to patients to decide.
In the meantime, combining DPC with locum tenens work isn’t a bad way to offer family medicine. To doctors who enjoy doing so, the DPC model represents a better way to offer primary care free from the shackles of typical health insurance. Taking locum tenens shifts on the side offers balance and perspective by getting the doctor out of his or her clinic and into new environments.