Clinic coming to Brattleboro eschews health insurance
There are no copays; there is no insurance paperwork.
That's because members pay a monthly subscription fee -- much like you would for Netflix or the gym -- to be part of the practice. It's
For Dr.
The subscription model is better for patients too, he said.
"Insurance in some ways can be a bit of a barrier for people and dissuades them from wanting to connect with the doctor because they are afraid they're going to get a big bill in the end of the visit. In our case, you don't have to worry about that," he said. "You can come and see me whenever you need to."
Hearth Stone began operating last year, and already Brickley and the clinic's other physician,
The clinic is part of a small but growing trend, operating under a billing model called direct primary care. DPC Frontier, a website that tracks direct primary care clinics, tallied 852 such clinics in 48 states -- four of them are in
Direct primary care addresses two of the most common complaints of primary care in the United State: Doctors often complain that they don't have enough time to spend with patients, and that administrative tasks cut into their already limited appointment times.
A 2018 study in the journal Family Medicine found that primary care doctors spend more time recording data in electronic medical records than face-to-face with patients. With the average appointment length hovering around 15 minutes per patient, according to a 2007 study in the journal
Short appointments can also affect patients.
Her experience, she said, was akin to a production line: Her doctor would rush through the appointment, leaving her little time to ask questions.
Even so, she was a little hesitant to move to the subscription clinic, she said, especially since her insurance offers what she said is excellent health care coverage. But ultimately, she chose to become a patient because she didn't want to feel rushed.
At the
One solution among many
Direct primary care bypasses health insurance billing, which emphasizes patient volume, said
But, he said, conventional primary care doctors can still give excellent medical care to patients. Direct primary care, however, is more convenient in that a doctor can address numerous issues with the patient in one visit. They can also devise a care plan with a specialist and deliver that care, rather than referring a patient elsewhere.
"It's not like you're paying for good care versus bad care. You're paying for easier access (and) making it simpler," he said about direct primary care.
However, he said, like many health care models, direct primary care may be just one answer to the problems faced by primary care physicians and their patients.
Brickley, for his part, said the subscription model helps him give the kind of care he wants to give patients, emphasizing relationship-building and education.
"I try to get to know my patients and understand what their values are and how I can best service them," he said.
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