Direct Primary Care is a grassroots primary care movement where physicians are bringing the practice of medicine back to its roots: the relationship between the patient and the doctor.   The practice operates, much like a gym, with a monthly membership in exchange for a broad range of primary care services.  The membership model enables a physician to maintain a smaller patient panel and prioritize increased accessibility, improved communication, and compassionate, quality patient care.  The benefits of the model include unlimited office visits, extended appointments, same-day or next-day appointments when needed, and more convenient methods of communication tailored to the patient’s preferences and needs.

Direct Primary Care (DPC) clinics offer concierge-level care but typically do not accept insurance. Based on the DPC model, YOU pay the physician, not the insurance company. The membership allows the physician to work directly for their patients and avoid the ever-increasing and costly documentation demands and administrative intrusions that come with accepting insurance.  Because DPC physicians avoid these obligations to insurance companies, they eliminate overhead costs and are free to devote their time to patient care. The result is more affordable healthcare and a stronger patient-doctor relationship built on trust and transparency.

Although insurance is not necessary for membership, it is recommended that patients maintain some level of health insurance to cover services you receive outside of the Lakes Region DPC such as specialist visits, hospitalizations, imaging studies, surgeries, prescription medications, and lab work.  Many patients pair Direct Primary Care with a high-deductible health plan to cover major medical expenses while keeping routine care costs predictable and affordable. 

Medicare requires that your Direct Primary Care physician withdraw from the Center for Medicare and Medicaid Services (CMS) program and agree to NOT bill Medicare for any primary care services provided to Medicare patients. Medicare patients must sign a waiver, declaring that neither you nor your doctor will directly bill Medicare for services received at Lakes Region DPC.  This waiver must be completed every 2 years.

Medicare benefits will otherwise remain unchanged and can be used for all other medical care received outside the practice including specialist visits, hospitalizations, imaging, surgeries, and prescription medications as usual.  

DPC works well for Medicare patients who want more personalized care and better access to their doctor and can afford the monthly membership fee for enhanced primary care.

Direct Primary Care differs from traditional primary care in several key ways, primarily its payment model, insurance involvement, and patient access.  Traditional primary care relies on insurance reimbursements, requiring copays and navigating complex billing processes.  Physicians in traditional practices are constrained by insurance requirements and large patient panels that often lead to rushed visits, limited appointment availability, and ultimately fragmented care.  The Direct Primary Care model relies on a fixed monthly membership fee to allow your physician to avoid insurance constraints and focus on providing high-quality, personalized, and accessible healthcare. 

With a smaller patient panel than traditional practices, DPC physicians provide more personalized care, ensuring thorough care coordination and in-depth visits.  This approach allows for close monitoring of chronic conditions, early detection of complications, and timely treatment adjustments, reducing hospitalizations and emergency visits. Patients have direct access to their physicians for timely medical advice and interventions when they matter most. And continuity of care fosters a deep understanding of your medical history, medications, and treatment plan, minimizing the risk of mismanagement. Additionally your physician will have more time to advocate for patients, coordinating specialist care, and facilitating necessary referrals. 

Everyone deserves medical care tailored to their individual needs. At Lakes Region DPC, we are dedicated to supporting your health and well-being. Preventative health visits provide valuable opportunities for counseling, reinforcing positive habits, and ensuring long-term wellness.  They also play a crucial role in early disease detection. Every visit, no matter the reason, is a chance to understand you better and foster a lasting relationship built on trust - so you feel supported if and when health challenges arise.

Services not covered by your membership include hospital and emergency care, complex medical care more appropriately managed by a specialist, imaging services and lab work, chronic pain management requiring the use of controlled substances, and DOT physicals and workers’ compensation and disability evaluations.

Since you are on our website, you are on the right track already!  If you like what you have read so far, I invite you to contact me so I can answer your questions personally.