Students Embrace Direct Primary Care
Finally, there is traction. Here are some highlights from the 2014 AAFP National Congress of Family Medicine Residents in Kansas:
Perhaps with an eye to the day when they’ll be hanging up their own shingles, residents strongly supported the need for educational resources related to DPC, adopting a resolution that calls on the AAFP to “explore the establishment of curricular experiences in the direct primary care practice setting for residents and medical students.”
A second resolve clause calls for the Academy to investigate the establishment of residency programs sponsored by DPC practices that would be self-funded, thus providing an option to increase available residency positions that would not require federal legislation.
“(DPC is) always compared to concierge medicine, but it’s much different,” said the resolution’s author Phil Eskew, D.O., of Heart of Lancaster Regional Medical Center in Lititz, Pa. “The cost is very low, and it often helps people who are uninsured.”
The congress also adopted two related measures, one of which asks the AAFP to create a DPC toolkit specific to family medicine residents who wish to establish a DPC practice right out of residency, as well as regional workshops on starting, rather than transitioning to, a DPC practice. The second measure asks the Academy to provide other educational resources on the topic, including seminars at the 2015 National Conference.
“As residents, the training we get in business models in general varies from program to program,” said Charla Allen, M.D., of Texas Tech Family Medicine at Lubbock, a co-author of both resolutions. “We believe a toolkit that would help residents coming out of residency would be very beneficial.”
This is “back to the future” for family medicine and I love it. In fact, I have hope again. Direct Primary Care is the only way we not only can survive, but thrive. In fact, that should be our mantra to these students and residents. DON’T JUST SURVIVE. THRIVE. I feel a tipping point coming.
DPC is not apropriate everywhere. I applaud that Atlas found a niche but go in an environment with an inordinate amount of Medicaid “gimees” (give me this, give me that) it will fail miserably. Meaning one will have to be in an area where the economy will bear it. If the specialty physicians refuse to see referrals from a DPC practice, it will put that physician in a terrible bind.
M.D. primary care is on its way out. I tell students, “Do you think the future is going to get better?” With N.P.’s P.A.’s and what have you, you think you’re going to be able to make a reasonable income? NO! Salaries are going to tank with the competition and one better pursue a marketable set of skills that are better compensated in the long run. Nobody is going to give you a retirement. If you have a family and a few kids to put through college, gonna be a lot harder being an FP who only does office work and nothing else.
Oh, BTW, the inefficient EHR makes so you do more uncompensateable work to further reduce your income!!
F.P. ~ R.I.P.
Your point about the Medicaid environment is true. That is why I moved to Va to do my DPC (starts in Oct). Since everyone has to have insurance or should have insurance, your specialist concern doesn’t exist. Primary care as we do it now is over. DPC is all we have left.
It is woeful to me that I might offer cynicism to your optimism, Dave, but honestly – what bureaucrat would let such as green sprout of Springtime, Direct Patient Care, survive? DPC can be crushed faster than the Prague Spring and the Tiananmen Movement. Them as has the gold, makes the rules. That’s the golden rule.
Wow so many doom n gloom naysayers.
There is a tipping point but we have not reached it. But the tipping point is never what we think it will be.
Wait and see what happens within the next 2-4 years. There will be big changes and physicians can either lead the change with patients by their side or physicians can become demagogued further and the ENTIRE profession is dead.