An AAFP Board Member Loves DPC?
I was amazed when I read this. John Bender, M.D., M.B.A., is a member of the AAFP Board of Directors and wrote this piece, which totally endorses Direct Primary Care! Am I living in Bizarro World? Will I have to start being nice?
Bender goes on to debunk all the myths about DPC, like how it would deepen the family physician shortage, etc. His information is sound but incomplete. Heck, at least it was a start. He should have referenced my book but I will let that pass.
Who knows, maybe 2017 will be a great year?
Perhaps it is like the challenges of perestroika and glasnost in the old Soviet Union. The leadership has discovered that the way the system works is irreparably damaged, impossible to improve. Rather than scaring the few productive members of the workforce, maybe the authorities can give them a little slack, so that they can become productive, and keep the others afloat?
It is clear from the article – and from the commentary – that they cannot continue the premise that DPC is bad. The cat is out of the bag, and nobody will believe it.
He cites one poison pill that the leadership has been touting – DPC as insurance.
“The third myth is that DPC is capitated insurance. This is pure bunk. DPC physicians do not take on underwriting or actuarial risk for the types of acute disease that subspecialists normally treat, nor for catastrophic or hospital care. They do, however, take business risk and must set the price point of their monthly subscription charge at a level that ensures revenues exceed expenditures to realize a normal business margin. As of June 2016, 16 states had laws on the books saying DPC is not insurance.”
Their effort is doomed, not ours. Their premise is, given the need to sustain and support the AAFP, ABMS and other control agencies, how do we improve the productivity of medicine? That was Gorbachev’s failing. The exhausted suckers just walked off the job, and quit. That strike shocked the controllers of big organizations such as the ABMS – surely, the farm animals can’t just quit! But they did. We should remember that.
The cognitive dissonance is stunning.
Dr. Bender seems to have no understanding that DPC is a complete rejection of everything the AAFP has been forcing on its members for the past decade – MU, PCMH, MACRA, etc.
His website advertises his practice as being both a NCQA PCMH and DPC.
Go figure.