Be Honest
Not sure that this meme requires much discussion.
Notice that I didn’t throw every DPC-adjacent insurance-affiliated entity (PCMO, etc.) under the bus, here. Models are emerging that save employers a bundle and include DPC fees in the premium, which saves employers/employees money…by taxes…or by carrying the one if it’s a Thursday during a full moon, vis-a-vis leveraging the interest on a non-conformative-premium-infused-synergistic self-funded ERISA-compatible ACA-compliant double-secret policy…or something…in theory.
Will that translate into increased wages for our patients (i.e. will the employer pass on this savings?) I mean, I sure hope so…but probably not.
Even if we had enough authentic full-spectrum 24-hours-on-call DPC docs to take the ocean of employees these PCMOs claim to have access to (which of course we don’t), the best ones won’t need the adjacent entities in the first place because they’ll be in demand by individuals. And why would they 1) put all their eggs in one employer-held-basket or 2) get entangled in separate contracts/middleman drama/expenses if they’ve got all the work they want without them?
Especially when they consider that it’s separate contracts and middlemen that originally morally injured them and drove them from the broken system? And if their answer is “because I can make more money” then they’re saying the same crap our ancestors said in the early days of managed care, and they should ask themselves where that money comes from. Hint: it sure ain’t the employer fleecing himself nor the insurance company executive selling off an extra summer home or yacht.
You are absolutely right on with this one Vance. I have been talking a lot with benefits consultants who joined the practice recently and there is a heavy push on their end to capture us all and make us DINOs (local DINOs posted up 50% reduced claims in early pilot programs and they all got excited). I was very clear from the start that none of us would be going back to the old insurance games, and that the next generation of benefits consultants would be working with DPC‘s directly to create the data themselves that they want to analyze, not the docs or the clinical staff. There has to be some way to tally all the wins, so this is the challenge I think pure DPC docs should solve in an elegant way that doesn’t slip back into darkness. Challenge is on all of us and we should all coordinate better as I fear the DINO bloom is on the horizon.