The Direct Care Option: Transparency, Access, Good Medicine
This post is Part 2 of a 3-part series. If you haven't already, please check out Part 1 here!
We're picking up where we left off at the end of Part 1 - what do we do about a system that is busted, and that itself needs medical attention?
My own view is that it won't do just to wait around until our elected (or otherwise) leaders do right by us and completely overhaul the existing system. We can - and should - change the paradigm at the community level. And there are a number of ways we can go about that from the ground level up.
One way we can accomplish that goal is by taking the middleman (insurance) out of the equation - at the very least, as much as reasonably possible. When an exchange occurs directly between patient and physician rather than going through a middleman like insurance, we refer to this as "direct care."
What Direct Care Actually Means
There is an entire growing movement of folks leaning into direct care.
Primary care providers, for example, may practice within the aptly-named model of direct primary care (DPC). In a DPC practice, for a flat monthly subscription fee, a patient gets unlimited access to their provider; full pricing transparency; appointment times that extend beyond typical 15-20 minute office visit model; medical decision making that happens strictly between patient and provider; and numerous other perks.
Patients frequently find that they spend less out of pocket for dramatically improved access with direct care. Direct care, in general, opens up a great deal of freedom for patients and providers without having an intermediary calling the shots from a distance.
There are a slowly increasing number of other types of medical practice (such as orthopedic) that are moving in this direction, too. And we count ourselves among those practices here.
How the Care Model at The Buddha's Medicine Works Financially
The Buddha's Medicine is not a traditional primary care practice; we are an Ayurvedic and integrative medicine practice, and it's important to make that distinction.
In some ways, though, this means we offer even more foundational and preventive care than primary care practices do, with our comprehensive prevention, lifestyle, and natural medicine-driven model. We readily recognize the immense value of DPC - and further, we draw inspiration from their approach to care freedom and financial transparency. We simply offer something different.
Being in the practice of direct care for our patients, we are up-front about any and all costs and investments. We can additionally tap into HSA/FSA funds if those are available; we can produce superbills for those with private health insurance plans, which count toward existing deductibles. Foundationally, though, we are in the business of caring for people directly and without interference, and ultimately, saving them money while we're at it.
And while we can (and do) lean into multidisciplinary care - coordinating with various specialists, therapists of different kinds, and more - our model is designed to get to the root causes of your (and/or your friend's or loved one's) health issues. We spend 3+ hours with each new patient at our first visit, reviewing any and all medical history, getting to know our patients at a deep level, and developing our initial plan of care while we're at it. We can (and do) take on prescription management when that is our patient's preference, and we're really good at reducing medication dependency and medication burdens on top of that. And it works; we see how much our patients thrive as a result of our approach.
Altogether, this reduces the need to seek excessive office-based visits with specialists, and also reduces the need for urgent care and emergency room visits. We commonly see that our patients save money going this route, and we are actively working on additional offerings to further save our patients money and improve their health outcomes.
What we deliver, then, is value - financial value, value via better health, value via robust access to your physician and care team, and value via peace of mind.
The Philosophy Behind Our Approach
Part and parcel of our model is that we conceive of healthcare very differently than many others do: as an investment in each person's thriving, quality of life, productivity (in any form), and also in their family and social circle - meaning, in those that love them.
Healthcare as Investment, Not Expense
How do we define the difference between investing in your healthcare, versus healthcare as an expense?
Healthcare is only an expense when it is not yielding the value, access, and healing opportunities that a person needs.
When an individual has no option but to seek an ER visit for an issue that they could not schedule an outpatient appointment for, that is an expense. And it's an expense that is often in excess of $1,000, and sometimes much, much more.
We save more than $2,500 per person per year when we spend $1 on effective diabetes prevention for each person. It's hard to overstate the significance of that. That is a solid, community-level example of investment in healthcare, as we're defining it.
And then there are the intangibles; the quality of life improvements that folks find when they have the opportunity to invest in their health, rather than spending in vain: the vacations and trips taken; the graduations and special occasions not missed; the hours spent walking out in nature and taking deep, comfortable breaths; the stress saved when someone does not have to spend hours navigating an insurance phone tree.
Financial Health as Part of Whole Health
Realistically, we know that financial health is part of whole-person health, too.
As we discussed some in part 1 of this series, the cost of living right now is very high, and it is going up by the day. This by itself - even when we take other challenges out of the equation - increases stress.
Much has been written about the stress-disease connection; we won't rehash that here, though there are lots of great posts adjacent to this topic on the blog already, including this one on how the nervous system operates from Jamie.
The short version of the thesis for this very big topic is: stress increases disease burden. It suppresses the immune system, and predisposes a person to infection. It increases systemic inflammation, contributes to insomnia and mental illness, exacerbates risk for all kinds of disease, and undermines healing.
Creating sustainable healthcare relationships is one way to help maintain financial health in the context of physician-patient and practice-patient dynamics.
How do we define a sustainable healthcare relationship? At The Buddha's Medicine, we consider a sustainable healthcare relationship to be a direct one: one wherein there is regular, consistent access and communication; one in which availability is high; one that is defined by trust and ample opportunities to develop that trust; and one that is financially transparent.
This is an aspect of the care and connection we offer to each and every patient of the practice.
Liberation from the Insurance Hamster Wheel
This all circles back to finding freedom from the corporate bottom line-based oversight of American private health insurance.
When we reduce our reliance on the financialized system such as it is, we have the opportunity to reclaim agency (as both patients and physicians) in making healthcare decisions that are actually in the interest of those seeking care. We also have the opportunity to build long-term health and support thriving, rather than constantly finding ourselves in the position of needing to manage crises. And we can develop substantially more wholesome and healing relationships with each other.
Still curious? Great - because there's still more to say! In Part 3 of this series, we'll discuss our commitment to a direct model of care, who that model best serves, and what you stand to gain by sharing in that with us.
And as always, Dr. Matt is available to discuss the ins-and-outs for you! If you are curious about your constitution & health (or health of a loved one), you can book a cost-free, 15min Consultation, and we’ll discuss!
Professional disclaimer: please do not initiate any herbal or other medicinal interventions without the guidance of a knowledgeable provider.
Dr. Matt Van Auken, MD, MPH
Dr. Matt is an Ayurveda-trained, triple board-certified physician.
