A Different Kind of Plan
MARBLEHEAD — Direct Primary Care is a concept based on the idea that physicians should be dedicated to their patients, and care for them based on their needs, not their insurance plan, says Dr. Jeffrey Gold.
The concept strives on building strong patient/physician relationships and eliminating third parties, such as insurance companies, for primary care.
Many believe it’s a solution to a lot of the problems we see in the primary health care system: waiting time, high costs, and not understanding treatments. Gold is one.
“Let’s get back to using health insurance for what insurance should be used for: the big things, the unexpected things, surgeries,” said Dr. Jeffrey Gold of Gold Direct Care in Marblehead, “not the day-to-day primary care which is expected and what people need.”
Instead, DPC offices charge a fixed monthly rate and provide patients with unlimited doctor visits and unlimited time during each visit. Doctors spend more time with patients and are able to provide a wider variety of care so that most procedures can be performed in the office, Gold says.
When a patient does need to be referred to a specialist, DPC doctors communicate extensively with the specialists in order to ensure the best care for the patient. “When I do refer out, I have a much better dialogue with the specialist,” said Gold.
“I have better referrals, because I’m not referring as many people out and I can communicate with the specialist because I have more time,” he said. “This results in better care for the patient, which is the ultimate goal and should be the ultimate goal.
“This is getting back to what medicine is supposed to be about, which is the patient and physician relationship,” said Gold. “The doctors in the program are trying to provide quality care but the current system doesn’t allow it.”
This method is an attempt to stray away from the traditional medical system, which Gold says has become more about “how many people you can see rather than the quality of the care.”
“Our goal is to help the patient,” he said. “It’s difficult when you’re in a room seeing 20 people a day. That’s not why I went to school for so long.”
Gold aims to have about 750 patients as opposed to the 2,500 he had when working in traditional medicine. The purpose, he said, is “for the patient to really have a lot of questions and be more engaged with their health. I have the opportunity to do that.
“It’s gratifying to spend time with people that you genuinely care about and make sure they are getting what that they need,” he said.
While DCP does not involve insurance directly, a membership does not take the place of insurance. It’s important to know that you still need insurance for emergency situations and surgeries.
“DCP is not insurance, it’s a service.” Gold said.
“All primary care services are included under that fee. I can still take care of someone who doesn’t have insurance but I would never encourage someone to not have insurance. We recommend a high deductible plan so that you’re covered in all aspects of your care.
“We’re trying to work with insurance companies to get the right plan for people. Get them higher quality care,” he said.
While eliminating insurance all together is not recommended, the idea behind DCP is to remove it at the primary care level.
“I work like a gym membership; people can use it or not use it but they’ve paid for the service,” he said.
“Patients pay “a monthly age-based fee that pretty much encompasses 99 percent of what I do in the office,” he said. Falling under the remaining one percent are things like blood work, routine women’s health screenings and even house calls, which Gold says range between $3-$30.
According to Gold, there are many added benefits of being a patient of a DPC office. Doctors have 24/7 availability. They give patients their cell phone number, giving them the option to call, text, email, FaceTime and skype.
“I can talk to a patient on the phone from the comfort of their own bed,” said Gold.
For Gold, it’s about changing the experience patients have with health care.
“Nobody wants to go to the doctor and we’re trying to change that,” he said “It’s up to us to try to fix this and make it better and the only way to do that is to think outside the box and make things simpler.
“It allows for people to have a say in what they’re getting and how they’re getting it,” he said “I hope we get to the place where people demand better and get better.”