Meet George. George is 23 years old, fresh out of college with a degree in economics, and has a new job at a bank. His job provides him health insurance and now he has the task of finding a new primary care physician. George considers himself to be very healthy and really never goes to the doctor. He stopped going for his yearly “physical” at 18 and now goes about once every other year for a sick visit. He takes no medications and has no chronic health concerns.
George comes across Direct Primary Care. He wonders why should I do this if I never see the doctor? As someone who is disciplined with his finances, he wonders: why should I pay more for a service I never use? The purpose of this essay to investigate the benefits of Direct Primary Care specifically for a young healthy person.
1. The Value of Prevention
George says, “But I never go to the doctor,” but maybe this is the problem. For a young adult with no medical issues, particularly one who is starting to go into the workforce and start living really independently, this is the opportune time to make and investment in one’s health in order to prevent dysfunction and illness in the future. In our society, we often do not address problems until they interfere with our function, but when it comes to health, there is a lot of value in taking proactive steps prior to something becoming a serious issue. Particularly nutrition, exercise, and lifestyle habits in one’s early years while they are healthy lay the groundwork for either a lifetime of health or disease.
In our current healthcare system, it is unclear exactly what this looks like. We are used to maybe having a 20-30 minute “physical” in which the doctor asks you a bunch of questions, examines you from head to toe, and sends you on your way. But imagine if the doctor really had an hour or more to really go into detail about exactly what you are eating, exactly what type of exercise regimen you were doing, or what skills you have to deal with stress. What if you got to follow-up with him regularly by e-mail and had someone to keep you on track and answer questions why they came up. Direct Primary Care offers a more personal relationship with your physician, which can work nicely with a proactive rather than reactionary health strategy for a young person.
2. The Membership Could Easily Pay for Itself
Regardless of how good George’s health insurance plan is, he will likely have some sort of deductible. Thus, for a person who rarely utilizes the health system, it is very likely that he will never meet his deductible and end up paying for a large proportion, if not all of his medical expenses if he incurs them. In our practice, George would pay $30 per month, which is $360 per year. If George were to need any sort of bloodwork or imaging or if we could save him one trip to the Emergency Room, the membership would easily pay for itself. Direct Primary Care is not insurance, but in a way, we might think of DPC as self-insuring against your deductible. If George had any say in his health plan, he might even choose a high deductible health plan (HDHP), which he could reserve for catastrophic care, and instead put the difference toward a Health Savings Account (HSA) and a Direct Primary Care (DPC) membership. The HDHP/HSA/DPC strategy is ideal for George and low-utilizers in general, as it would certainly lower his overall healthcare costs and increase access to high-quality primary care.
3. Young People Also Have Medical Issues
George may not realize this, but young people are not invincible from medical problems. Adolescents and young adults often feel like nothing could happen to them, but this group does access medical care and has a unique set of issues. Issues surrounding sexuality (contraception, STDs), mental health issues (anxiety, depression, ADHD), sports-related injuries, skin issues, and substance abuse to name a few. When these issues come up for a young adult, it can be scary and overwhelming, and having a physician who you can easily access, who you can trust makes all the difference.
As a society, we need to reframe how we look at primary care. It has the potential to be more than a yearly chore, primary care can have significant impact for a healthy, low-utilizing young adult who wants to take proactive steps for his health and his healthcare.