1) The Wedge - My thanks goes out to Twila Brase for all her work over the years to encourage health freedom. Most recently she developed a new resource called "The Wedge of Health Freedom." We have the DPC Mapper for DPC practices, but this group is planning to aggregate a listing of practices (primary care, specialty, and surgery) all over the country that care about offering transparent cash pricing. It is a resource worth checking out! It should make it easier for new DPC patients and physicians to navigate the rest of the health system in an affordable manner.
2) Self Insurance - More employers are opting to "self insure" and this is great news for DPC practices. This story from Kaiser Health News is worth a quick read. Transparent pricing options (such as DPC) and decreased regulatory restrictions make the "self insured" space more appealing.
"[P]olicies sold to companies in the small group market — in most states, defined as companies with fewer than 50 workers — are required to cover 10 so-called essential health benefits and are restricted in how much they can raise premiums based on age or tobacco use. Self-funded plans don’t have to comply with those requirements. They also avoid most federal and state taxes on health plan premiums to health insurers."
3) AOA Board Certification - A class action complaint has been filed by Albert Talone, DO, Craig Wax, DO, Richard Renza, DO, and Roy Stoller, DO against the American Osteopathic Association in the US District Court of New Jersey. Here is a copy of the complaint which makes many allegations. The suit was covered in the Philadelphia Business Journal. Here are some of the most salient excerpts.
"In order to obtain and maintain their board certification, Plaintiffs and the Class have paid millions of dollars of registration, examination, certification and processing fees to the AOA. In addition, they pay an annual board certification maintenance fee. The AOA has notified Plaintiffs and the Class that even though they have already paid these fees and have been qualified and recognized as board certified medical specialists, their board certification will be invalidated and cancelled unless, in addition, they also purchase annual membership in the AOA. To avoid the loss of their board certification, Plaintiffs and the Class have been forced to purchase AOA membership even though it serves no purpose with respect to and has no actual connection with AOA board certification. The AOA's annual regular membership dues presently are $683 per year. It is estimated that the AOA is receiving more than $20,000,000 per year by unlawfully forcing AOA membership on Plaintiffs and the Class under the threat of invalidating prior board certification. Defendant's practice of forcing AOA board certified osteopathic physicians to purchase annual membership in the AOA dues constitutes a per se illegal tying arrangement in violation of Section 1 of the Sherman Act 15 U.S.C. § 1 and Section 3 of the New Jersey Antitrust Act § 56:9-3 under the 'rule of reason' that has caused and will continue to cause damage to Plaintiffs and the Class."
As DPC physicians we need to step back an analyze all costs associated with the practice of medicine. Board certification and maintenance of certification are costly (in terms of dollars and time). For physicians in the traditional fee for service system there is not much choice - they can comply with these requirements or face pay cuts and possible loss of hospital privileges. Pure DPC physicians have a choice to make. They must independently decide if board certification adds value to their practice. Does it make you a better physician? Are your patients asking you to do this? My advice is simple. If you think it adds value, keep doing it. If you think it fails to add value, then stop.
What do you think about any of these three topics? Please comment below!