The Difficulties With Insurance-Based Primary Care
In my last post, I told you why I love primary care. It was a picture of what primary care could and should be. When primary care works well, it helps patients to stay healthy and happy.
Unfortunately, largely due to the pressures of insurance on primary care physicians’ time, much of primary care has changed from the ideal of keeping patients healthy to something much less satisfying both for patients and their medical team.
Due to the amount that insurance companies pay for patient visits, primary care physicians can only spend about 15 to 20 minutes per patient visit before moving on to the next patient if they wish to keep their practice financially afloat.
Even the most seasoned, knowledgeable, and efficient family physicians run behind in this type of system. This is why patients so often feel rushed, interrupted, and are stuck coming back to the office for repeat appointments to discuss other issues. Their doctors objectively do not have enough time to do all the things they need to do in such a short visit. This time crunch leaves less space to:
- Really listen to people
- Think critically about what might be going on
- Connect the dots between multiple different symptoms, and
- Be emotionally available for and empathetic with patients (something I find so important in caring for my patients)
Insurance pressure on primary care results in rushed appointments, rapid decision making, poorly explained plans, patient frustration, and burnt-out doctors.
I want to be very clear that I do NOT think that these negative changes in the current primary care health system are a result of bad doctors, bad nurses, bad medical assistants, or bad staff. The healthcare workers I know regularly go above and beyond to take care of patients with compassion and professionalism. I was daily humbled by the people I worked with during my training in Colorado, and the primary care health providers I know in the New Braunfels area are no exception to this kind of high standard. However, they are all facing the significant limitations put on them by insurance company involvement in primary care services.
When it comes to primary care, insurance involvement makes holistic, empathetic, comprehensive care more difficult. And it does so without making that care more affordable.
Insurance has inflated the cost of nearly everything in health care. By cutting insurance out of the equation in primary care, direct primary care gets rid of the insurance inflation while providing the kind of holistic, empathetic, and comprehensive care that patients desire and that doctors desperately want to provide. As DirectMed DPC’s website so elegantly puts it, this is family medicine like it used to be.
(Insurance is still very important for many situations, such as emergencies. With car insurance, you don’t send a bill to your auto insurance each time you get gas or an oil change. But when you hit a deer in the Texas Hill Country, that insurance is important to have. Importantly, when you have a direct primary care doctor, you can choose an insurance plan with a lower premium, and a higher deductible, knowing that must of what you need can be provided by your direct primary care doctor without ever involving your insurance. This approach can save families and business a lot of money on health insurance premiums.)
Stay tuned for next week’s blog post to learn about how to do primary care a much better way!
