My favorite medical show is “Royal Pains.” No contest. Best one there ever was. It exemplifies
the glory of primary care physicians and the relationships they have with their patients. While growing
up, my family and I would watch episodes of “Royal Pains” and my parents, being physicians, would
shout out differentials as the show progressed. The show depicts an ER physician cast out of the
corporate medicine world for making the right, moral decision. He then takes a vacation to the
Hamptons after his whole world has collapsed around him and soon develops a medical practice based
on a direct payment model. His account brother runs the financial side of the business allowing Hank,
the protagonist physician, to be able to focus on the medicine side with no distractions. Hank falls in
love with his role as a primary care physician. He treats all types of people in the Hamptons from the
ultra-wealthy to the lowly fisherman who pays in the day’s catch.

Growing up I knew that I wanted to be a physician, but I always wished I could do it just like
Hank. House calls and providing great quality care to whomever is in need of it. No worries about
payments or meeting metrics of specific items in the note, having reimbursement tied to whether my
patients actually complete smoking cessation. And if there is a little “MacGyver medicine” with random
things in the immediate vicinity then even better.

I feel that today’s physician shows are all screaming the same message. “The Resident”, “New
Amsterdam”, “The Good Doctor”, they are all depicting the moral physician fighting against a broken
system. They show rules being bent to meet the patient’s needs and to provide better care. How is this
not a reflection of the community’s feelings of the healthcare system we live in? It seems everyone
would be much happier with Hank’s system of direct payment. It would bring happier physicians and
happier patients. Luckily, I found that system: direct primary care (DPC).

“Royal Pains” shows great traits that a DPC clinic should have to be successful. Hank’s successful
practice was based on trust built through quality relationships he made in the community. A couple of
patients receiving quality care from him spread the word about how great a doctor he was, and this led
to random people through the community calling him for their medical needs. His practice boomed from
there. Hank was very flexible in his practice. His private practice was thrust upon him. He transitioned
from the safety of a salary in corporate medicine for the FUN of private practice. He flexed to the needs
of his community. His PA, Divya, provided a SUV stuffed with portable medical equipment making
Hank’s practice mobile. Assert yourself, Hank fights for his patients calling in favors to get his patients
the care they need. He also asserts himself to his mysterious and powerful landlord laying out his rules
and boundaries for their relationship. Hank will not be taken advantage of in the relationship as a
physician or a friend.

We should all be like Hank. We should be the physicians we dreamed of as children. Providing
moral medicine to those in need; asserting ourselves to not compromise our boundaries. We should
create great relationships with the members of our communities. All of this is possible through the
direct payment model that puts physicians and patients in charge of the healthcare. I know that my
dreams will be coming true as I pursue my passions through my DPC practice. So strap on the DIY,
Entrepreneur mentality. Muster all your “Outta-my-way-I’m-going-to-doctor” attitude and make the
jump to DPC. Practice your medicine morally. Do DPC and practice medicine the way your community
wants.

Ben Hauter is a PGY2 at SIU Family Medicine in Springfield, IL. He was inspired to pursue primary care by
his parents whose small-town practices had great impact on their community. Ben’s passion for DPC led
to his parents exit from fee for service and creation of their DPC clinic: Central Illinois Direct Care. Ben
plans to finish his family medicine residency and start his own DPC practice. He Lives with his wife,
Brittany, who works as an occupational therapist, and their two dogs.