What is Direct Primary Care And Why Should I Use It?

If you're curious about Direct Primary Care (DPC) and how it differs from Concierge Care, you're in the right place! While at Liberty Advanced Integrative Care we use the DPC model, both models have emerged as alternatives to the traditional insurance-based healthcare system. While they share similarities, the two are distinctly different in several key areas—particularly in cost, structure, and philosophy.

What is Direct Primary Care (DPC)?

Direct Primary Care is our healthcare model that focuses on providing patients with comprehensive primary care services through a straightforward payment structure. Instead of dealing with insurance, patients pay their providers directly—usually through a monthly or annual fee—which covers all primary care services. This includes routine check-ups, preventive care, chronic disease management, and even minor procedures.

The simplicity of DPC’s structure has some major perks:

1. Affordable Access: DPC practices generally charge lower fees, averaging around $75 to $200 per patient per month. Oftentimes additional family members can be added for a fraction of the initial membership fee. This fee covers a wide range of services like longer visits, same-day or next-day appointments, virtual consultations and sometimes even home/in-hospital visits, (American Academy of Family Physicians (AAFP)).

2. Fewer Patients, More Time: With a smaller patient panel, DPC physicians can spend more time with each patient. On average, DPC practices see fewer patients than a traditional practice, which leads to more personalized and attentive care​, (Journal of the American Board of Family Medicine (JABFM)).

3. No Insurance Hassles: One of the most appealing aspects of DPC is that it operates outside the complex world of health insurance. This means providers spend less time on administrative tasks and more time with patients​, (AAFP).

Concierge Care: High-Touch, High-Cost

Concierge care, on the other hand, is often associated with high-end, personalized medical services. It originated in the 1990s when physicians sought to offer exclusive healthcare services to wealthier patients. Patients pay a higher fee (sometimes upwards of $2,000 to $5,000 annually) for perks like 24/7 access to their doctor, extensive preventive screenings, and detailed wellness plans ​(Northern Virginia Family Practice (NVFP)).

Concierge care tends to attract more affluent individuals who are looking for highly personalized attention and extended access to their doctor. The key differences here are cost and the potential overlap with insurance. Many concierge practices still bill insurance companies for services like lab work, same day appointments, or hospital visits, which DPC practices typically do not.

Major Differences Between DPC and Concierge Care

While both DPC and concierge care emphasize a more patient-centered approach, there are significant differences:

1. Cost and Accessibility:

   • DPC: Low monthly fees ranging from $75 to $200 make it more accessible to the average patient. Many DPC practices are affordable enough to serve middle-income individuals or even contract with employers to provide care for all employees at the company​ (JABFM)

   • Concierge Care: Membership fees can be much higher, often between $2,000 to $5,000 annually. This puts concierge care more in line with wealthier patients who can afford such premiums for enhanced services​ (NVFP)

2. Insurance Involvement:

   • DPC: DPC practices do not accept insurance at all. They rely solely on the membership fees paid by patients. This makes the healthcare experience much simpler and less prone to the inefficiencies caused by insurance billing. Patients in DPC practices often carry a high-deductible insurance plans for catastrophic care which is generally more affordable than an all encompassing comprehensive plan ​(AAFP).

   • Concierge Care: In contrast, concierge practices often still bill insurance for services while charging a membership fee on top of that. This can lead to higher overall healthcare costs for the patient​ (NVFP).

3. Service Scope:

   • DPC: The membership fee in a DPC model covers nearly all primary care services. This includes office visits, physicals, in house lab tests, and minor procedures. While some services, like specialist care or major surgeries, aren’t included, DPC practices often offer discounts on non-primary care and expanded service offerings​ (JABFM).  Direct Patient Care providers will advocate for using insurance in other realms of healthcare, like for labs, radiology or specialist care, where insurance is more cost effective as a means to save money.

   • Concierge Care: The higher membership fee in concierge medicine often covers more comprehensive wellness exams and may include things like personalized health plans or extensive screenings. However, concierge care practices might not provide as broad a range of routine care under the membership fee as DPC does​ nor offer anything other than primary care services (NVFP).

4. Target Patient Population:

   • DPC: This model often appeals to a broader range of patients, including families, middle-income earners, those with challenging health issues that need more care than a 15 minute appointment can provide, those who prefer not to deal with insurance, and those that want to have an expanded relationship with their medical provider ​(AAFP).

   • Concierge Care: Concierge practices cater primarily to affluent individuals who value exclusive access and are willing to pay more for it. The model is often seen as a luxury service​ (NVFP).

The Philosophy Behind Direct Primary Care

A significant philosophical difference also underpins the two models. DPC emphasizes value-based care, where the primary goal is improving overall patient outcomes through continuous and comprehensive primary care. By not dealing with insurance, DPC allows doctors to reduce overhead costs and administrative burdens, enabling them to focus on preventive care and long-term health management​ (JABFM). 

In concierge care, while patients certainly receive more attention and access to their physicians, the model is still somewhat tethered to the insurance system. This means that, unlike DPC, which strives for a clean break from traditional healthcare hassles, concierge care continues to navigate the complicated billing practices and requirements associated with insurance.

Why Choose Direct Primary Care?

If you’re someone who is frustrated by rushed appointments, surprise billing from insurance, or simply want a more personal relationship with your doctor, DPC might be the perfect solution. Here are some of the main benefits:

1. Personalized Care: With fewer patients to see each day, your doctor can spend more time with you, addressing not just your immediate concerns but also focusing on your long-term health​ (AAFP).

2. Cost Transparency: In a DPC model, there are no hidden fees or complex insurance claims. You pay a set amount each month, which covers all the primary care you need. No more surprise medical bills​ (AAFP & JABFM).

3. Flexibility and Convenience: Most DPC practices offer same-day or next-day appointments, virtual consultations, and even house calls, making it easier to fit healthcare into your busy life ​(AAFP).  Care where you need it, when you need it.

4. Preventive Focus: Because DPC providers can spend more time with their patients, they can focus on preventive care—catching potential issues early before they become serious health problems, oftentimes offering functional options for those that prefer​ a more integrated and holistic approach (JABFM).

   
   

While both Direct Primary Care and concierge care offer innovative solutions to the traditional healthcare system, DPC stands out for its affordability, transparency, and focus on comprehensive primary care without the involvement of insurance. It’s an excellent option for those seeking high-quality, patient-centered healthcare at a reasonable cost, and it truly empowers both providers and patients to build lasting, meaningful healthcare relationships for the benefit of the individual patient and the community the provider serves.

References

American Academy of Family Physicians (AAFP): https://www.aafp.org/family-physician/practice-and-career/delivery-payment-models/direct-primary-care.html

Journal of the American Board of Family Medicine (JABFM): https://www.jabfm.org/content/28/6/793

Northern Virginia Family Practice: https://nvafamilypractice.com/nvfp-media/traditional-medicine-or-concierge-medicine