WHAT IS “DIRECT SPECIALIST CARE” AND WHY?
Is Direct Specialist Care a new concept? No. Not at all. You may think of it as form Concierge Medicine without the price tag! Let’s answer some questions for you.
Why Direct Specialist Care?
As many of you know, I have been practicing Interventional Pain in Saint Augustine for 35 years, treating patients with painful arthritic conditions, sports injuries and spine conditions. Along the years as we all have noticed, the practice of medicine has become more and more controlled by insurance companies and hospital executives, to the point that if a physician is going to play by their rules the patients suffer with high deductibles ($5000, $7000 and higher) and copays ($15, $25 and even $50 per visit) and by not getting the indicated treatment recommended by the doctor because the insurance company want to save money by not approving it. Additionally, there is a high percentage of physicians experiencing burnout because of the stress of it all and having to jump through all the hoops! What is the solution, you may ask? The solution is really simple and will save you money and grief and provide you better care. You may have heard of Direct Primary Care. Well, we have created “Direct Specialist Care” to provide you the care that a primary care doctor is not trained to provide .
The insurance model imposed on us is so outrageous that even in view of the high insurance premiums paid by patients that can afford them, they still face outrageously high deductibles and copays that the patient has to pay out of pocket before the insurance company pays a dime for them. Unfortunately, most of patients find out about this when they arrive at the doctor’s office and it really hits home after repeated office visits for procedures etc. because it all comes out of their pocket! So, say you are one of those that can afford to pay for a health insurance policy. Let’s say the monthly insurance premium for you alone is $500 and you have a yearly deductible of $5,000. That means your yearly cost out of pocket before the company pays a dime is $11,000. Wow! Compare that to the cost of our plan for a year! (@ $1,500) And with our plan you get services and perks that no insurance plan covers!
On top of the above, the physician faces all kinds of barriers, such as not getting approval from the insurance company to order this or that test (e.g., MRI) which he feels the patient needs after performing the appropriate physical exam. Instead, the doctor gets told by an insurance company employee (not a doctor) that before they approve that test (MRI), the patient will have to complete six weeks of physical therapy or conservative therapy. In the meantime, the patient suffers with the pain.
Presently there is a push to see more and more patients and do more of what pays the most, to the point that medicine has become a revolving door. In an out quick kind of care. It has become more about checking boxes than caring for patients. Ask yourself why patients use urgent care and pharmacy clinic more and more instead of their primary care doctor or their specialist office. Why? The answer is simple. Often at their primary care office or specialist office there is two weeks wait, because they have to see more and more patients. Additionally, you can’t get anyone on the phone because they are so busy or if you leave a message usually takes a long time to get a call back. Finally, when they get scheduled, they will sit in the waiting room for a long time and then, if they are lucky, they get seen by the doctor or at times, if they are not so lucky, by a physician assistant or nurse practitioner, for five minutes and are told not to worry, “that is nothing serious”. It’s called rush-rush-rush kind of medicine. This nationwide problem occurs in all specialties unfortunately.
Given these above-mentioned issues, the traditional insurance healthcare model has made it increasingly difficult to see patients in the manner that I believe is necessary to provide good care. This is why we have made these changes in our office.
I hope that this Direct Specialist Care model we are creating for our practice becomes popular. Patients will be better served and the practice of the specialty will be more what it should be: a physician-patient relationship eliminating the front office routine, insurance billing, and administration routine. Basically, a more personalized care. With a Direct Specialist Care practice there is less volume of patients, which allows same day or next schedule day appointments, timely appointments without undue wait, unhurried appointments, ability to interact directly on the phone with the doctor, have the ability to offer the patient the technology available when needed and not when the insurance allows it.
How does it work?
Think about your Amazon Prime or YouTube subscription plan. Every month, you pay a flat fee and gain access to priority or free shipping or their TV shows and movies. In our case, the Direct Specialist Care membership plans provides you a certain number of visits and clinical services, easy access to appointments, better communication with the doctor (email, text, phone), and give you access to specialized medical care. Direct Specialist Care do not charge copayments, and they don’t send you a surprise bill.
Do I need a membership plan to be seen?
A pre-enrollment first visit is always needed to see if we can be of help you and if we are a good fit for your medical care. Signing up for the membership is required to continue care in our practice.
Here are the benefits for members:
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Longer time with the physician one-on-one
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No rushed appointments
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Better patient-physician relationship
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Direct communication with the physician by cell phone or text
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Same day/next schedule day appointments
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Personalized referral when needed
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Transparent pricing disclosed up-front
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No surprise bills
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No copays or deductible
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Discounted pricing on labs
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Discounted pricing on imaging studies
I look forward to the successful introduction of the Direct Specialist Care type of practice. The practice model all patients deserve!
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