Here is a moronic opinion in a recent Annals of Internal Medicine. The article is called Did CMS Just Undercut Arguments for Direct Primary Care? and it is written by Brian Block, MD, a member of ACP’s Council of Resident Fellow Members. So….a resident. No experience in the real world.
Here is this blockhead’s pertinent points and my counterpoints:
- By removing the insurance company and engaging in a patient-pays-clinician model, these practices become financially out of reach for many patients. (So $50 to $80 a month is out of reach for many patients? There is no data to support this other than the fact that 95% of direct primary care practices are successful. I guess he should be protesting cell phone plans too? Aren’t they out of reach for these same people too?)
- For example, by reducing patient panels (to an average of 900 rather than 2300 patients) DPCPs can limit access to physicians. (The same old argument. Since we have less patients in our practice therefore it is our problem to find care for the others. Why is it MORE morally ethical to rush through visits in seven minutes and see 30 patients a day than it is to see 10 patients a day 30-60 minutes for each visit? It isn’t. It’s just dogma.)
- Disadvantaged communities and persons of color shoulder most of these losses. Indeed, a nationwide study found that DPCPs served fewer African American and Hispanic patients (this is a study from 2005 of high concierge practices. Talk about cherry picking! DPC wasn’t even around then. Welcome, you earned your very own FAKE NEWS card).
- DPCPs interested in improving health care delivery and value should consider embracing these payment models and welcoming patients with Medicare and Medicaid into their practices. (I have Medicare and Medicaid patients in my practice. I just don’t bill Medicare and Medicaid. I do NOT want the government involved in paying me. That is why I left).
This dude knows nothing of what he talks about. He is a resident. He has never worked a day in the real world and isn’t even going into primary care. And he is ALL IN on the government fixing the model they destroyed. Well, Dr. Block, it is all yours for when you graduate. I am never going back.Tweet