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Why Direct Care Isn’t about the Money

Daniel Paull MD says that cash based practices may seem like they are all about the money when, in actuality, they are about autonomy.

Ask almost any direct care provider why they decided to do direct care and almost none of them will say it’s primarily about the money.

Almost all of them will say it’s about autonomy and control.

Over time as physicians, we have had our autonomy over our own practice slowly erode.

We used to be able to make decisions based off on what was the best course of action for the patient.

Now the hospital systems and insurance companies force our hands.

Of course hospital systems and insurance companies will deny this practice, but it is obviously true.

 

We used to be able to make decisions based off on what was the best course of action for the patient. Now the hospital systems and insurance companies force our hands. Click To Tweet

 

 

Once a hospital system buys a primary care practice, the first thing they do is increase the workload of the physician to make them “more productive”, even if that means worse care.

Now the physician doesn’t have a say on how many patients they see a day. More patients usually means worse care for each one.

 

We used to be able to make decisions based off on what was the best course of action for the patient.

 

 

Insurance companies are masters at attrition.

Want that necessary MRI for your patient? Here are 5 hoops you need to jump through, with the last one being an hour long phone tree maze to do a peer to peer.

 

Insurance companies are masters at attrition. Want that necessary MRI for your patient? Here are 5 hoops you need to jump through Click To Tweet

 

We have lost almost all of our autonomy with one party telling us how to practice, and the other making us jump through hoops for trivial reasons.

These are the reasons that providers go into direct care.

 

With direct care, you get full autonomy.

You can truly take into account a patient’s multiple problems, social, and economic situation.

The money comes later, and if you do the right thing and put the patients first, it always comes.

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