A primary care direct pay model that works

by Brian Forrest, MD

When I started a cash-only, direct-pay practice nine years ago, my reasons were simple: spend more time with my patients, provide better care, and live a better life.

I was uncomfortable signing insurance contracts that limited my ability to care for my patients. I was unwilling to sign an employment contract that required me to see a patient every 7.5 minutes, or lose a productivity bonus.

Nine years later, my practice Access Health Care in Apex, North Carolina is living proof that primary care physicians can provide better care to more patients more economically while making significantly more income if we start answering to our patients instead of answering to insurance companies or government bureaucrats.

Our model attracts a lot of interest:

  • Interested in low cost? How about a patient reducing her expenses managing her diabetes from $5,000 per year to less than $500?
  • Interested in improved outcomes? How about 91% of patients achieving their target blood pressure within 6 months? How about being named one of only four Cardiovascular Centers of Excellence in our state?
  • Interested in quality of life? How about only scheduling eight patients per day, leaving ample time for walk-ins and same day appointments, and never seeing more than 16 patients per day?
  • Interested in reducing professional liability? How about your malpractice premium being cut in half, and having zero risk of Medicare recovery audits?

As word about my practice began to spread, I began answering questions from other physicians looking to start or transition their own practices following our Direct Pay model. Over the past five years, those questions evolved into a consulting practice helping over 75 physicians across the country, in specialties ranging from family medicine to ophthalmology.

In the wake of health care reform, and with physicians facing financial stress from reduced reimbursements and increasing Medicare recovery audits, interest in alternative practice models is surging.

It is time to get off the treadmill of factory medicine, and return medicine to doctors and patients.

Brian Forrest is a family physician and is the founder of Forrest Direct Pay.

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