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Monday Sep 28, 2015

Questions About DPC? FMX Sessions Offer Answers

I recently received an email from a physician who was just out of residency and contemplating his future career options.

"Even as a resident, I was incredibly frustrated by the limitations placed on my primary care practice by billing and documentation demands and disillusioned by the lack of support for caring for patients beyond the four walls of the clinic," he wrote as he explored the possibility of starting a direct primary care (DPC) practice.

Since I presented at the Direct Primary Care Summit in July, I have talked with a wide range of physicians with nearly identical sentiments. Some are seeking tangible advice on starting a DPC practice, some are just venting, and others have given me words of encouragement.

Given the variations and rapid growth of DPC, it's difficult to pinpoint an exact number of direct-practice physicians. However, at least 500 DPC practices are now operating, and the vast majority of them opened in the past 12 to 18 months.

It's clear from my email inbox that there are thousands more physicians considering making the switch to DPC and many of them have questions.

This week, the AAFP Family Medicine Experience (FMX) in Denver will give physicians more opportunities to learn about DPC, including a dedicated track. "Delivering Patient Care, Not Paperwork" is scheduled for 8-11:30 a.m. on Oct.1 in Room 201. The session repeats at the same time on Oct. 2 in Mile High Ballroom 4D.

I will be joined by Josh Umbehr, M.D. and Doug Nunamaker, M.D., who practice in Wichita, Kan. Together with attorney Michael Campbell, we plan to cover a wide range of DPC topics. A key distinction between a DPC practice and a traditional, insurance-based practice is the relative simplicity of operating the business. However, there are many unique considerations when owning and operating a DPC practice. The questions I have fielded have been numerous, but here are a few of the common ones we will address:

  • Should I go fully direct or keep some insurance contracts?
  • How should I notify my patients if I switch to the model?
  • What can I do with Medicare patients?

On a broader front, the DPC track will cover three main areas, including

  • reviewing the unique features of DPC and relationships with other models;
  • practical steps in starting a new DPC practice; and
  • legal aspects of DPC practice, including Medicare issues.

On Oct. 3, there will be a meeting of the DPC member interest group (MIG) -- which is now the largest of the Academy's 11 MIGs -- from 8-10 a.m. The meeting will feature an open discussion of DPC-related topics, and leaders will give a legislative update and conduct elections of new officers for the group.

The flexibility of DPC allows it to fit a group of patients and a community and is one of its greatest strengths. Doctors can creatively tailor their practice to meet those needs, but we hope to first set the stage by sharing the framework and common traits of a successful DPC practice. I'm hoping the upcoming events at FMX will help further explain how DPC can be a viable option for family physicians and the health care system.

If you're not able to join us in Denver, be sure to keep an eye out for future opportunities to learn more about DPC practice. Upcoming AAFP-hosted DPC events include an Oct. 24 workshop in Dallas and an April 2 workshop in Detroit next year.

Ryan Neuhofel, D.O., M.P.H., owns a direct primary care practice in Lawrence, Kan. You can follow him on Twitter @NeuCare(twitter.com).

Posted at 08:43AM Sep 28, 2015 by Ryan Neuhofel

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