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.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  4 comments for “Students Embrace Direct Primary Care

  1. Kurt
    August 27, 2014 at 10:17 am

    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.

    • Doug Farrago
      August 27, 2014 at 10:35 am

      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.

  2. August 27, 2014 at 7:41 am

    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.

    • DoctorSH
      August 30, 2014 at 9:21 am

      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.

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