Doctor Wants to Kill Netflix by Pat Conrad MD

Hey, does this sound familiar?  Just up the road from King Doug in Lynchburg, another Direct Primary Care spark has flamed up in the region.  Dr. Maura McLaughlin has a DPC practice in Charlottesville, Virginia, “one of nearly 700 nationwide.”

Here is some info from her website:

“Ages 0-30 years: $30/month, discounted to $15/month if enrolled with a parent.  Ages 31 years and up: $60/month”

What does that get you?

Clinic visits for chronic and acute problems; reduced labs pricing; preventive care for adults and children, and GYN care; certain procedures “for cost of supplies ($20)”; nights and weekend physician access, and “Treatment over the phone when medically appropriate”; home visits for an additional fee (and free for newborns and hospital follow-ups).

And I just love this quote: “The model itself works sort of like Netflix,” Dr. McLaughlin says.  “They can use the services here as often as they need to.”

“Chuck Gulat isn’t rushed when he sees his primary care doctor. He comes as often as he wants, and doesn’t need insurance to pay for it … Patients like Gulat are still encouraged to carry a lower cost insurance plan to cover medical emergencies …  Gulat comes every three months for his high blood pressure and diabetes.  ‘Hands down, it’s made me physically healthier, and financially healthier.’  He’s now saving about $1,300 a year.”

The patient is happier and has more money in his pocket.  The doctor is happier, and doubtless giving better care (arguably a chicken-egg question, so feel free to debate).

I like Netflix.  I like convenience, and knowing exactly what I’m paying and exactly what I’m getting.  And I like competition, and knowing that I can discontinue something I don’t like.  I like choices.  Who could possibly argue against this?

“Critics, like Dr. Ed Weisbart with Physicians for a National Health Program”, that’s who.  Weisbart is quoted in the lead article wringing his hands over what he believes will be a growing shortage of primary care doctors, “since these [DPC] doctors see fewer patients.  Also, high deductible plans leave specialists uncovered.”

“That opens the door to this huge range of medical problems, that fall in-between the catastrophe and primary care.”  So is Weisbart just another Stockholm-Syndrome, hapless family doc beaten into submission and lack of imagination by a crushing system?  Not exactly.

Weisbart is a nationally recognized advocate for single-payer health, who “now volunteers in a variety of safety-net clinics in the St. Louis area and is also assistant professor of clinical medicine at Washington University in St. Louis.”  Now a humble volunteer and academic, he once was once a practicing family doc for 20 years, just a simple, altruistic, if misguided remnant of a noble profession, right?  Not exactly.

In 2003 he left his practice “to become chief medical officer at Express Scripts, a Fortune 100 Company. After retiring from that position in 2010, he began organizing the St. Louis chapter of Physicians for a National Health Program, which he currently chairs.”

Whoa, whoa, let’s back up.  This expert on how other doctors should make a living himself RETIRED from a Fortune 100 company??   So the guy that advocates a system that will trap physicians into a greater web of government mandates, himself escaped from primary care to turn what I imagine was some pretty good coin, before returning to academia and the volunteer life.  But didn’t his time at Express Scripts reduce his availability as a primary care doc during a time of worsening shortage?

Yes Weisbart, if there is any good left in medicine, thinking physicians like Maura McLaughlin will add to the growing rolls of DPC practices, and definitely worsen the shortage of your preferred kind of primary care docs.  The McLaughlin’s and Farago’s of the world are increasing patient satisfaction, providing better care, and leading happier lives.   You Prof. Weisbart want doctors dragged back into a despair pit of increased workloads, flat wages, more meaningless administrative data gathering, anger, depression, and health commissars telling everyone what to do.

While Direct Primary Care is offering the next Netflix, you want to force us all to go back to watching PBS.

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107300cookie-checkDoctor Wants to Kill Netflix by Pat Conrad MD