Dr. Muney said that the direct primary care model could represent “the salvation of the health care system,” because it saves costs while significantly enhancing the physician-patient relationship. However, to make the model work well, patients would need to resist the urge to demand unnecessary tests and specialist visits, and insurance would need to be restructured to eliminate primary care.
In addition, insurers may view new direct primary care clinics as competition, which could lead to fights between insurers and the clinics if the model were to be adopted in many locations, advocates of the approach say. And the clinics themselves would need to resist the urge to add too many patients to their panels, or physicians could find themselves spending less time with each patient.
Despite these obstacles, Dr. Bliss said she also believes that the direct primary care model can solve the inherent problems in the current health care system, and solve them better than the patient-centered medical home model.
In fee-for-service practice, “the only way you can make money is to lay eyes on the patient, and the only way to see enough patients is to have all those people tee up the patients for you,” said Dr. Bliss, who said she became burned out after a few years of fee-for-service practice despite a deep commitment to primary care. “This model can fix what’s wrong with health care. It can make patients happy and it can make primary care physicians enjoy practicing again.”