Why go outside of traditional insurance?
The healthcare system in America is broken. Everyone knows it, but no one has known what to do about it. Until now.
Many families are finding that traditional insurance coverage is leaving them uncovered. And when they get to the doctor, they don’t feel heard because the doctor is overwhelmed by insurance company rules.
The healthcare system in America has become incredibly bloated - and as a result, incredibly expensive. Those costs are passed on to you, in the form of high premiums, co-pays, and costs for labs and diagnostics.
Meanwhile, your doctor is equally frustrated - he or she is overworked with tasks that happen after hours or during “lunch” (most doctors don’t actually get a lunch break). Prior authorizations, coding for appropriate billing, long, tiresome notes that are less about communication and more about documentation to justify an ever-shrinking reimbursement - all these contribute to physician burnout.
North Carolina has one of the highest percentages of doctors who are “owned” by hospitals or Private Equity companies.
Doctors sell to hospitals or private companies to be relieved of the burden of business ownership and to enjoy higher reimbursing contracts. But this comes at a cost, because insurance companies never decide to pay more, they always, year after year, pay less. The CEOs and CFOs know that the only way to combat lower reimbursement is to see more patients for a shorter period of time. This solves the math problem but it doesn’t lead to better care, and it leaves both doctors and patients dissatisfied.
The answer to the problem was first broached in the 1990s and has grown into a nationwide movement, called Direct Care. In this model, doctors decline participation in insurance contracts, cutting out the middleman. As a result, they are free to doctor the way they always wanted to - by fostering relationships with patients, providing education and the time and space to discuss the issues that concern you and your loved ones.
The miraculous part of all this is that when you eliminate the middleman, costs for patients actually go down!
As an example, when you need your thyroid checked, it costs $33 at LabCorp when you use your insurance, but only $3 when you pay directly. The same degree of savings is seen when you go for CT scans, MRIs, etc. GoodRx is based on this same principle.
Many people are finding that to afford traditional insurance, they have to buy high-deductible plans - and never even meet the deductible. So really, they are getting catastrophic-care policies, but are using them as if they were actually useful. A better approach is to think of health insurance the way we think of auto or life insurance - it’s there if we need it, but we hope we don’t. Please note that I don’t recommend that you go without health insurance - I just recommend that you think about it differently, and choose your plan accordingly.
The Direct Primary Care movement already has a strong presence in the Raleigh-Durham area, and they need specialists to refer their patients to. That’s where I come in.
I am excited to return to doctoring the way I thought I was going to be able to do it when I went to medical school.
I’m excited to have more time with my patients, getting to know them as people because I find that to be the best, most gratifying part of my job. I’m thrilled at the prospect of educating and partnering with my patients as we work toward optimal GI health. And I am absolutely thrilled with the team I have assembled.
This is a new chapter in my career, and in my life. I’m taking a leap, and I hope you’ll join me!
