I'm Back! 1) Why Wyoming, 2) More research soon, 3) Website Updates

To all my blog readers in the DPC community - please accept my apologies for the long gap between posts.  I run of conferences recently finished and I am finally finding the time to make some needed updates to DPCFrontier.  I have some major updates to share.

First - I am often asked why I chose to move to Wyoming when I had no prior connections to the state.  My response to this question was just published in the Nov/Dec version of the West Virginia Medical Journal (pages 8-9).  I'd be happy to hear your thoughts about this in the forums.  

Second - One week from today a comprehensive DPC research manucript entitled "Direct Primary Care Practice Distribution and Cost Across the Nation" will be published in the Journal of the American Board of Family Medicine.  It should serve as a resource for the entire DPC community when speaking with policy makers and other interested parties about the model. As you might have notices, we do not have too many academic articles available at present.  

Third - I have added a few new events (things tend to quiet down in the winter season).  Please let me know if any are missing.  A new version of the mapper should be up in the next few days.  I am also making a more concerted effort to add detail to each state page, including the most relevant portions of the insurance code, HMO, and similar concerning language when available.  By way of example, check out the detail on the Alaska page.  Eventually I'll get to every state - if you have a priority request - feel free to let me know in the forums.

Finally, I find myself more and more short on time.  If you or someone you know would like to play an active role in DPC Frontier - please shoot me an email (phil@dpcfrontier.com)- especially if you have coding (squarespace) experience or are interested in research collaboration.

Lowering Barriers to Entry - Avoid Bad Consultants (ABC)s

I am happy to hear about more and more physicians entering the DPC space.  The mapper I have been working on for years now has over 355 practices.  As the DPC movement continues to gain momentum physicians must be aware of the parasites that are sure to follow.  Many "consultants" claim to have expertise in DPC.  While I have met a few kind and helpful consultants, most claim knowledge that they simply do not possess, and then overcharge physicians for "services" of little value.  

In the next few blog posts I will be pointing out many of these cases.  I have quietly and politely said nothing for too long, and too many physicians are paying for bad information, when excellent information is totally free on this website and the many other resources we cite.  One of the ABCs of DPC should be "avoid bad consultants."

One group of consultants in an article picked up by Reuters claims that:

A)"DPC is best viewed as a fee-for-service model, in which patients pay out of pocket at the time of service for care received"  - Anyone with half a brain knows that this is not an appropriate definition of DPC (appropriate definition found here).  The starting point for DPC fee arrangements is the periodic fee - just ask the 14 states that have passed laws on this very issue.
B) "The majority of medical services in a concierge model are delivered directly by the physician, while patients in a DPC practice are more likely to receive a significant portion of their care from a nurse practitioner or physician assistant"  This is false.  I have data that directly refutes this statement, and it is scheduled for publication in the Journal of the American Board of Family Medicine next month (check back on Nov 6th).
C) "In DPC, there is frequently no cap on the number of patients accepted, and to make the model work financially, patient panels easily number well over 1,500."  This is also false.  I have not met a single DPC physician that plans to operate a practice with a policy of no patient cap.  Having no patient cap would not only be legally risky and foolish, it would be unsustainable and prohibit the physician from continuing to offer enough time to each member patient.

For some reason the authors of this article chose to cite my website.  I have no idea what they were citing it, since they obviously have not taken the time to read it.

Federal Update, NC Update

Direct Primary Care Coalition - We had an excellent meeting in DC last week.  Thanks to the efforts of Jay Keese and other members of the steering committee SB 1989 the Primary Care Enhancement Act now has bipartisan support starting with Senators Cassidy and Cantwell.  The bill would make it possible for DPC patients to have and use health savings accounts for DPC periodic fees and also establishes a pilot program where Medicare would pay the periodic fee for Medicare patients without requiring current DPC physicians to change their opted out status. 

North Carolina - Thanks to the efforts of Brian Forrest North Carolina is closer to having DPC widely available to all NC Medicaid patients.