Direct Primary Care vs. Concierge Medicine — Know the Difference

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Direct Primary Care vs. Concierge Medicine — Know the Difference

In the 21st century, medical care is evolving to keep up with patient needs.

These days people are looking for a more comprehensive medical service. Many people are not satisfied with a 10-minute doctor appointment anymore and are seeking a way to get more in-depth consultations with a primary care physician.

There are two models aiming to solve this problem. One is called direct primary care and the other is called concierge medicine. But how do they work and what’s the difference? Keep reading to find out.

What Is Direct Primary Care?

The direct primary care healthcare model allows physicians to provide medical services directly to patients for a monthly or annual fee. This way, insurance companies are ‘cut out’ of the equation.

The membership fee paid by the patients grants them access to a variety of services. This includes some lab tests, sick visits, and annual exams. Apart from the membership fee, the patient does not pay again at the time of service.

Although DPC is a relatively new model, it’s continuing to grow in the US. According to the Direct Primary Care Coalition, more than 1,200 new primary care practices have opened since 2009.

Advantages and Disadvantages of Direct Primary Care

The direct primary care model has a number of advantages over a traditional physician’s practice. Doctors working in direct primary care spend more time with each of their patients – around 30-60 minutes.

Doctors in traditional clinics that rely on health insurance reimbursement spend on average 12-15 minutes with a patient. Direct primary care physicians see around 10 patients a day whereas traditional doctors can see more than 30.

Consultations with a direct primary care doctor are more in-depth and allow for the fostering of a deeper doctor-patient relationship. Patients are also happy because their care is covered by one monthly fee instead of separate copays for each procedure.

Most direct primary care centers also allow electronic communication between doctor and patient via email or video call. This gives patients the flexibility and convenience of contacting their doctor when they’re unable to be physically present. Usually direct primary care practices limit the hours that patients can contact the doctor, and “after 5” availability is not standard.

Patients pay the same membership fee regardless of how much care they receive in a given month. The downside is that this may cause direct primary care centers to limit care.

Patients should familiarize themselves with what’s included in their membership fee so that they can plan financially for other procedures outside the scope of the direct care program. As many as half of all direct primary care patients may be uninsured, relying on their membership for health coverage.

What Is Concierge Medicine?

Concierge medicine refers to a healthcare model where patients pay a recurring fee for round-the-clock access to their physician. Concierge medicine provides patients with same-day appointments and highly-personalized, comprehensive medical care.

This type of care comes with a cost. That’s why patients who use concierge medical care are usually high-income earners.

The average cost of a concierge medical care membership is between $1,500 and $2,400 per year. Although there are practices that charge a lot more.

Advantages and Disadvantages of Concierge Medicine

Like direct primary care, doctors working in concierge medicine are able to spend up to an hour with their patients. This allows the patient to receive care that is comprehensive and customized. Many concierge doctors provide mobile numbers to their patients so they can be reached after hours for health issues. 

With this model, many doctors feel they are able to offer high-quality care to all of their patients, which cannot be said for those working in traditional clinics. Patients also feel they have been properly taken care of. Some concierge services even offer house calls.

Concierge practitioners are not burdened with administrative tasks so they can direct all their energy to patient care. Those living with chronic conditions benefit from having all-day access to a physician with an intimate knowledge of their medical history.

The nature of small medical practice care gives physicians the ability to be selective about who they treat. Patients with chronic conditions should be aware that specialty services are not covered under a concierge membership. It’s important for all patients to understand exactly what their membership fee covers.

Are you still unsure of the differences between direct primary care and concierge medicine? Here is a brief outline.

Membership Fees and Cost

With concierge medicine, the cost is higher than it is for direct primary care. DPC fees are usually paid on a sliding scale depending on age. In other words, younger patients pay a bit less than older patients. Depending on the practice, family rates may also be available.

Most concierge medicine membership fees are charged annually whereas DPC fees can be paid monthly.

Services

In the DPC model, the membership fee covers unlimited patient visits. There is no limit to how much care a patient can receive. The annual fee for concierge medicine covers unlimited patients visit, extended hour access to the physician and in-depth physicals and screenings that go beyond what a traditional practice would offer.

Both models offer direct access to a primary care doctor, whether in-person or over video call/email. DPC doctors are out of network, making it hard for them to advocate for patients with outside specialists or other hospitals. Concierge doctors are in-network providers meaning they don’t have this difficulty.

Third-Party Reimbursements

Many concierge practices accept government programs and insurance plans. And patient visits are billed as they would be at a traditional clinic.

In the DPC model, doctors do not accept insurance reimbursements. Membership fees cover basic appointments and anything outside of that is charged separately.

Deductibles

The annual fee paid by patients for concierge services is not deductible, but any related health costs are. For DPC services, memberships are not deductible and neither are additional fees (such as lab fees, etc).

Growth

Concierge medicine is most common in affluent areas. It’s a niche service that has been growing since the early 2000s. There are also more concierge doctors than DPC doctors.

The DPC model is also growing. DPC practices are most common among rural communities that face physician shortages.

Medical Care for an Evolving World

Direct primary care and concierge medicine are both new and successful medical care programs. Both models aim to provide patients with comprehensive, personalized medical care that they wouldn’t get at traditional clinics.

Both DPC and concierge medicine offer many benefits including longer appointment times and direct access to a primary care provider.

Are you interested in learning more about concierge medicine? We offer our patients a comprehensive, concierge house call service. Contact us today to find out more.