D
- Joined
- Jul 28, 2004
- Messages
- 27,963
- Reaction score
- 56,388
Ugh, I truly hate that policy person from UVA. Her worries are all overblown and based on her own speculation and nothing more.
First, despite what she claims, there is absolutely good evidence that DPC saves employers significantly - its just not been published in any journals. I'm about to start a job with Paladina Health (mentioned in the article) and have seen the figures for the job I'm taking. For the 800-ish covered lives this location takes care of, total expenditures have been on average 15% lower each year since Paladina took over. If there weren't savings, businesses would abandon DPC.
Second, this quote just pisses me off "There are no additional quality-control eyes that look at physicians to see: Are you practicing evidence-based medicine? Are you overtreating? Is there overdiagnosis?" Apparently without corporate overlords, none of us are capable of being good doctors.
Third, "And doctors might be tempted to cherry pick patients, given that they’re paid the same monthly fee regarding how many appointments the patient makes, Engelhard points out. Why not pick the healthiest individuals, she asks, to fill those membership slots?". I can't speak for other docs, but most of my patients are actually pretty sick. A monthly fee is a harder sell for someone who goes to the doctor once/year. Besides, you can make the same argument for anyone. I think we all know plenty of docs in every setting that refer out anything complicated. I would posit that in DPC that's actually less likely since the main reason for weak referrals is not wanting to take the time to mange complex conditions. Not an issue for DPC. As it stands now, I take care of way sicker patients than I ever did when I was FFS.
- Joined
- Nov 25, 2009
- Messages
- 132
- Reaction score
- 143
I need to learn how to cherry pick healthy patients better.
I've been filling my DPC panel during my growth period with two types of patients, stable patient who knew me from my insurance practice and a small but significant percentage of very sick patients. I often have several on hospice or in the local hospital. With under 600 patients, that's a lot.
As we set up more employer agreements and my DPC panel matures, this will get better but anyone making statements like that about DPC doesn't know what she's talking about.
I've been filling my DPC panel during my growth period with two types of patients, stable patient who knew me from my insurance practice and a small but significant percentage of very sick patients. I often have several on hospice or in the local hospital. With under 600 patients, that's a lot.
As we set up more employer agreements and my DPC panel matures, this will get better but anyone making statements like that about DPC doesn't know what she's talking about.
