Medical training is hard… but that was not the surprise. We all knew that when we started this journey down the path of medicine that it would be difficult. We do it because we believe it will pay off, that there is a light at the end of the tunnel, that in the end, we will be able to have a job that we love. As a third year family medicine resident, almost at the end of my training, I had finally made it to the end of that tunnel. I was almost there, but I could not help but think that this life of traditional primary care that I was supposed to embark on was not really what I signed up for.
In the beginning, when I signed up for this journey, what I wanted was to take care of people. I chose Family Medicine because I wanted to have perspective on the whole person, not individual organ systems, and I wanted to care for people over time, become a trusted advisor in their lives, and grow old with my patients. But modern primary care doctors are unhappy and unsatisfied with their jobs. They are rushed, forced to see patients too quickly, pressured to concentrate on paperwork and billing, and to top it off, they are paid less than any other specialty.
I had heard of Direct Primary Care in medical school, and had always had it in the back of my mind for something to consider later in my career, but as I looked at my options at the end of residency, I realized that immediately after graduation was actually the perfect time to do it. The question of whether or not the model of DPC makes sense for a medical practice was a no-brainer. Not only do most patients end up saving money, but this structure allows for a level of care, attention to detail, and thoughtfulness that truly leads to improvements in health and disease prevention. The challenge was going to be the business side. Was I willing to learn how to be an entrepreneur? Was I willing to take the financial risk? Was I willing to overcome the fear of doing something different?
Direct Primary Care is now in a unique position for rapid growth. The pioneers have come and laid the groundwork for us. They have already dealt with the operational, financial, and legal issues and have proven that the model can work. In Massachusetts, Dr. Jeffrey Gold of Gold Direct Care has created the blueprint for what a successful DPC practice can look like, so that doctors like myself do not have to re-invent the wheel, and can quickly build successful practices.
But the real reason to do this and to do it immediately after residency is because it’s the right thing to do for my patients. I see people every day who are “insured”, but cannot afford to get healthcare. Increasing deductibles are forcing more people to pay out of pocket and more patients are opting to forgo their care due to cost. Additionally, patients that are expecting their visits to be comprehensive and their doctor to truly advocate for their health are surprised to walk out of the appointment feeling like they are just another medical record number to be dictated at the end of the day. I realized during my residency that I don’t want to work for insurance companies… I want to work for my patients.
So when I told my co-residents that I would be starting my own Direct Primary Care practice, not one of them even questioned why. In fact the most common response was “I wish I could do that too.” I was privileged to have attended an incredible residency program, and when I told my advisors and mentors about my plans, they quickly understood that my decision was based solely on a desire to restore the patient-physician relationship and often remarked “that’s the way it used to be when I trained.”
Doing something different and new is always scary, but our country needs us to offer creative and innovative solutions to our broken healthcare system. For me, I am building a practice where I will get to do what I set out to in the first place when I started this journey: to care and fight for my patients, and in the process, restore the honor and integrity of the profession that I love.