An increasingly popular, new type of health care fresh to San Antonio has some doctors abandoning billing through traditional means in favor of a membership-fee model.
Called direct primary care, physicians say it allows more time with patients.
The DPC model bypasses insurance, copays and deductibles, opting instead for a direct billing arrangement between doctor and patient that resembles a subscription membership paid on a monthly, a quarterly or an annual basis.
In exchange for payment typically ranging from $35-$100 per month, clients get access to numerous primary-care services including same- and next-day appointments, wellness checkups, laboratory and consultation services and telehealth contact (phone, video chats or texting), plus more quality face-to-face doctor visits.
“Many patients are disappointed in how the system works because they don’t get to spend that time with the physician, and that’s totally opposite from the direct-care model,” said Dr. Prisiliano Salas, who opened his DPC practice, Salveo Direct Care at 11503 N.W. Military Highway, Suite 111, last October.
“The traditional model fee for service is very time-limiting for patient encounters,” he added. “The average time is seven minutes in the traditional practice, and we really get pushed to see a large number of patients to meet the demands of the insurance companies.”
Salas, who has been practicing medicine since 2011, started using the DPC model after becoming frustrated with the traditional health care system, which he feels has thrown a bureaucratic monkey wrench into providers’ abilities to treat patients due to having to meet insurance companies’ criteria.
Under DPC, doctor appointments last from 30-60 minutes, which was the primary reason family practitioner Dr. Roger Moczygemba, who operates Direct Med Clinic at 1010 N.W. Loop 410, Suite 100A, adopted the process. He noticed more companies gravitating toward it as a way to provide benefits to their employees at a lower cost.
According to the American Academy of Family Physicians, besides more access to, and time with, medical professionals, DPC rewards patients by offering lower costs and more preventative care.
“It puts the control of the health care dollar back into the hands of the people who are paying for it,” Moczygemba said. “We’re no longer bound by the constraints the insurance companies put on us to take care of patients in a way that we feel is going to be best for them. We can spend more time with patients and not have to rush through the visits, and do what’s right for them.”
Dr. Chrissy Navejar, who opened an independent DPC and 24/7 concierge-care practice called Dominion Primary Care, 23535 Interstate 10 West, Suite 2205, said she enjoys being able to build bonds with customers.
“They can text, and call me, and email, so it allows us to better manage concerns,” she said. “It builds a stronger relationship with doctor and patient because there’s no intermediary.
“From a provider perspective, this is the happiest I’ve ever been since I started practicing medicine,” she added. “I would highly recommend (it) for any docs graduating residency to look at this model.”
While many healers are lauding the personal and financial benefits DPC affords patients, its proponents — and critics — say it’s no substitute for medical insurance, advising those with a monthly direct primary care subscription to also possess a high-deductible health insurance policy for handling catastrophic illness or emergency.
“Insurance was designed to take care of the big stuff,” Moczygemba said. “We’re just trying to get people to go back to using insurance the way it was designed.”