As a teen, I bussed tables at a fancy restaurant. I loved flirting with the old ladies (my age now), troubleshooting the room and getting paid to hustle. I guess that’s why I used to love family medicine before I became an “employed physician.”
Unfortunately, I also saw the dark side. The mouse in the lettuce, the dropped food getting plated and the cooks having sex in the cooler.
Then one day, one of my best friend’s father asked me if he should take his wife to my restaurant for their anniversary. Being only an idiot kid, I didn’t know what to say—but my friend’s dad told me my hesitancy spoke volumes.
There is no more trusted voice than one from the inside.
Last week I posed the question as to whether, if you can afford it, you should spend the extra $75-$100 dollars each month for your own personal clinician, such as through a Direct Primary Care practice.
These direct primary care clinicians provide the full spectrum of primary care services in exchange for an additional monthly payment. There are no contracts, no commitments, only good care.
But is it worth it?
You’re already spending $500 or more a month for your insurance—or your Medicare A, B and D.
Is it worth the extra money just to have your own personal clinician?
My inner busboy says yes. Absolutely yes.
Ask yourself what it is your paying for.
A counselor, an advisor, a confidentialist whose only goal is in serving your interests.
Once purchased, what would such a service look like?
Well, it would be centered on you. Provided at your convenience and need. Addressing issues that are important to you.
Now, look at the healthcare your insurance premium purchases.
Care at your provider’s convenience. Addressing issues of importance to your provider. Centered on making sure all the fields in the electronic health record are filled in.
Are those issues important to your health? Possibly. Even Probably.
But they are not YOUR issues.
A famous saying is often quoted about social media like Facebook: “If you’re not paying for a product, then the product is you.”
Twitter, Facebook, Instagram all hate this saying—because it unmasks the truth.
When you use your insurance to see your provider, it’s your data that’s the product.
Your insurer doesn’t care one whit whether or not you feel the risk of a false positive mammogram outweighs the benefits—they want you to have one—badly.
And they’re willing to penalize your clinician financially and professionally if you do not. They will cut her pay, try to humiliate her by publishing in mammogram rates, and characterize her as low quality in order to coerce her to do what they think you need done.
Your clinician is the piper—but your insurance company is paying the money, so they get to call the tune.
Don’t believe me?
Try to contact your clinician after hours.
When I first started practice 25 years ago, it was expected that I should pick up the phone when a patient called—I was selling personalized medical care.
Try that now through a healthcare system. Your call is answered by a nurse you’ve never heard of, answering your questions using guidelines designed to get you to a venue where you have to pay for care.
Now try calling your DPC clinician.
They’ll pick right up.
Still, I’ll bet you’re saying that healthcare is obscenely expensive. And that you can’t do without insurance to cover you against catastrophic loss.
What to do?
Accept that the insurance premium you’re paying is essentially a very expensive catastrophic plan—covering you in case of something expensive and scary like a bypass or cancer.
Use your own money to get the healthcare you need — you deserve.
I don’t work at that restaurant, and I don’t do DPC.
But I’ve seen both from the inside.
I pay $24,000 per year for health insurance for my family.
And I also pay another $1,200 for my own personal clinician.
If you can afford it, I suggest you do too.
Presented as a service—for you.