5 Things Direct Primary Care Doctors Do Differently
1) We take our time.
Good, quality care takes time. There's no way to really understand a patient and their health problems or concerns without getting to know them, their lifestyle, their personal and family history, etc.. I love getting to understand my patient's jobs, their families, and what their day-to-day life looks like. It gives me an insight into potential health issues they may be at risk for. An executive and a plumber are both at higher risk for certain health problems, just different ones.
"If you listen to the patient carefully enough, he will tell you the diagnosis." - Sir William Osler
One of the most fun (and challenging) parts of medicine is that all patients are different. While two people may both have high cholesterol, one patient might be curious about following a more natural approach to treatment by modifying what they eat and how they exercise. The other might be interested in starting medication, but may have heard about a friend that had a side effect to a cholesterol medication and may be hesitant to start. Most people want to avoid having a heart attack or stroke, but they need more information about how their cholesterol relates to those diseases, as well as their options for treatment. Given the chance, most people will share their concerns and questions openly.
2) We focus on lifestyle changes before prescribing medication.
Talking about lifestyle changes also requires time. Really making a difference involves doing a lot more than saying the words "diet and exercise." Sure, there are medications for chronic health conditions when we need them, but many patients are able to control these conditions with lifestyle modification - including improved diet, new or different types of exercise, stress reduction, improved sleep, etc. These all take time to discuss, and since I've been practicing direct primary care, I've found myself with the opportunity to really delve into these topics with patients. As a result, I'm seeing so many more of my patients control their health conditions with lifestyle modification alone. Even if we still need medicine to help control their high blood pressure, diabetes, or high cholesterol, by optimizing their lifestyle factors now, we know their life will be longer and healthier in the long run.
3) We see our patients as often as needed - not based on an insurance company's guidelines.
Sometimes patients want to be seen and say they're "not allowed" to because their insurance said they already had a physical in the last calendar year. Unfortunately, traditional practices and insurance are based on a model of sick care - meaning rather than being proactive about health, the tendency is just to treat you when you're sick. In these practices, insurance dictates when and how often you can be seen. The best part of direct primary care is that we get to make a plan with our patients regarding their best plan of care. (Shocking, right?) So now I have a quite a few patients that I meet with monthly or every other month to monitor changes and suggest areas for improvement. And so many of them are making great strides in their health!
4) We're old school.
We believe in personal relationships. We want to see our patients every visit, because we know them best. We believe when our patients are sick or have an urgent health concern, they should be seen as soon as possible (again, by us, whenever possible.) We make house calls when necessary. Like most other direct primary care doctors, I love caring for the whole family, because I find I'm able to do a better job taking care of each family member and anticipating their health concerns and needs when I know the whole family well.
5) We embrace technology and innovative methods for care.
While our approach to care is old-fashioned, we also embrace technology and other new ways to care for our patients. Direct primary care doctors were doing telephone and virtual visits long before the pandemic, because they found them to be convenient ways to connect with their patients. When we have something that requires more discussion than physical exam, it's often easier for my patients to do a quick virtual visit rather than leaving work to come into the office. Similarly, my patients often email me lists of their home blood pressure or blood sugar readings, and we can make adjustments to our treatment plan as needed. Just this week I had a parent text me a picture of her daughter's rash, and I was able to text back a diagnosis and recommendations. I love knowing my patients are getting the care they need, and I love that I can make it more convenient for them!