Recently, I spoke to a primary care doctor who completed his medical residency less than a year ago.
Since then, he’s struggled with the constraints and demands of working within a traditional primary care practice. And, in that short time, he’s already questioning his career choice.
Why is this young doctor so disillusioned with traditional primary care? Because that healthcare model is not just broken — it’s rapidly failing for the following reasons:
- Traditional primary care practice doesn’t attract enough American Medical School graduates.
- Higher insurance costs force primary care doctors’ salaries to flatten or decrease year over year, so the specialty is considered lower-paying.
- Within traditional practice, primary care is managed via a standardized process — an algorithm of sorts. With each patient, the physician must follow a prescribed routine of checkboxes and paperwork mandated by insurance or administrators: “You are someone with X condition; we do Y for it, so Z will happen.” There’s little time for personalized, thoughtful attention to the individual.
- With most of their practice reduced to a process, medical practices often find it simpler and less costly to have mid-level providers (nurse practitioners or physician assistants) see patients.
Spreading the Word About Direct Primary Care
Most primary care doctors in traditional practice have never known another type of healthcare. But in concierge practice, we know there’s a better way.
Because we’re not bound by the insurance system, we truly put patients first. We’re responsible for a limited number of patients, have more time to spend with them, and are free to make thoughtful diagnoses and treatment plans, unconstrained by insurance limitations or one-size-fits-all guidelines.
We encourage doctors in the traditional healthcare system to break from insurance and government involvement in healthcare. Instead, connect yourself with a direct primary care or concierge practice, where your incentives align with the patient’s.
A Day in the Life of a Concierge Doctor
As a primary care doctor myself, I can be a much better physician who focuses on individualized healthcare in a concierge practice.
My mission is simply to keep every patient as healthy as possible, and I accomplish it because:
- My patients see me quickly whenever they need me.
- I devote plenty of time to each one.
- I have greater freedom in how I treat them.
- I take the time at every physical to forecast possible concerns and address them immediately.
- I fully apply my specialty and skills to help each patient with specific or personal health goals, from attacking diabetes to running a marathon to end-of-life planning.
- I let patients share their opinions or express concerns about treatments.
I enjoy coming to work and having productive, interesting conversations with patients. Recently, I chatted with a soon-to-be dad who questioned whether he’d ever have his new child vaccinated. In 15 minutes, I explained why vaccines are medicine’s greatest invention. He left convinced.
That’s a win for him, his family, my office, and society at large, all because concierge practice allowed me quality time to have that conversation.
At five o’clock, I head home, have dinner with my wife and children, and attend my kids’ soccer games, rather than spending late hours providing documentation that insurance-based healthcare systems require.
Not Enough Primary Care Doctors
In an ideal world, primary care specialists are the quarterbacks of the healthcare system. Their role should be to decide where and how patients are treated or tested and to focus on preventive care.
Unfortunately, the number of primary care doctors in America is declining. Medical school graduates often opt for other specialties, like neurology or cardiology, where they earn significantly more than primary care doctors. Seventy percent of U.S. medical school graduates enter subspecialties; just 30% choose primary care.
Our goal should be to flip that ratio until 70% of medical school graduates choose primary practice. If that happens, the broken system will fix itself.
- There will be enough primary care doctors to give every patient the access to physicians they deserve.
- Doctors will have time for more extensive examinations and deeper conversations with their patients.
- Doctors will have the choice and ability to adapt patient care beyond what traditional practice dictates.
Higher Costs for Doctors and Patients
As the U.S. patient population grows, the number of healthcare administrators increases — the same administrators who write the playbooks primary care physicians must follow.
This graph of America’s spending on healthcare shows the relentless rise of administrative vs. medical spending, particularly over the last two decades:
Traditional primary care doctors are also squeezed in other ways. Insurance companies frequently dictate what a practice can charge for patient treatment. However, the same insurance providers decrease reimbursements to primary care physicians, forcing doctors to see more patients to make the same living.
In the U.S., the current shortage of primary care physicians also affects patient healthcare costs. Because it can be difficult to find — and get an appointment with — a primary care doctor, frustrated patients are forced to manage their own health journey without the experience or knowledge to do it well.
Often, patients bring their medical issues to a subspecialist, which may cost them more (and be less effective) than sticking with an informed primary care physician.
For example, the patient may pay quite a bit for exams and testing, only to find the subspecialist still can’t get to the root of their problem. Perhaps they lose time and money moving from specialist to specialist without finding a solution.
But 80% of what a subspecialist finds could be identified by a good primary care doctor — one who takes responsibility for reviewing the patient’s health issue, uses solid clinical skills and new technology to diagnose, and determines how to proceed with treatment.
What’s the Answer?
For the U.S. healthcare system, the biggest challenge isn’t finding new patients — it’s finding good doctors! As the population grows, that need will amplify across the U.S.
Yet, interestingly, I still speak with doctors who’ve never heard of direct primary care or concierge medicine. At medical schools, deans often hesitate to advise medical students about this kind of practice. Residency directors often place their medical residents with local hospitals and practices and fear disrupting that connection to their community.
At Priority Physicians, we spread the word about concierge and direct primary care by inviting more people — both doctors and patients — to visit us and understand how we work and by encouraging more medical students to enter the primary care specialty.
We’re in the lifeboat, waving our arms at primary care doctors and yelling, “Come join us! We have the solution!” We can elevate primary care doctors. And we welcome the idea of more of them.
Learn More
Are you a doctor who wants to hear more about primary care practice in a concierge setting?
Are you a patient who wants your physician to prioritize your family’s healthcare?
Reach out to the Priority Physicians team. We’re happy to talk!
