Starlight Health is a Mobile Direct Primary Care that offers those who are fed up with the expense and inconvenience of the traditional medical system, a simple membership plan with no hidden fees, no long term contracts, and no surprisesGet direct access to your own personal provider whos there when you need it, where you want it and who can help you feel secure about your health at a price that’s actually affordable.  Join the Direct Primary Care revolution by scheduling a free consultation today.We can come to you!  We see our patients in the comfort of their own home, our office, or anywhere else in the immediate Fort Collins area.

What is Direct Primary Care?What is Direct Primary Care? It's a simple enough answer with incredible changes and results. In its basic form, Direct Primary Care is when patients contract directly with a healthcare provider. That's right, I do not mean contracting with an insurance agency, I do not mean being assigned a doctor, I do not mean being forced to be in a network and getting bounced from one doctor to the next in an endless battle of who's going to deal with you. Direct Primary Care is you picking your provider, contracting with them directly, end of story.So why does this matter? How much of a difference could it really make to contract directly with a doctor instead of by using insurance? The answer is... A lot. The difference Is profound, not just financially, but in the quality of care you receive. The traditional healthcare system works on a concept known as fee-for-service. This is a concept that has been around for generations, ever since the inception of modern medicine and has served us well in the past.  Over time though as various entities have become involved, as the prices have skyrocketed, and as the volume of patients has increased.. the fee-for-service model has become outdated and has become a source of many of the problems rampant today. Because of how the �usiness of medicine has become structured, doctors and healthcare providers are now forced to see more patients in the day, spend less time with them, and perform in an endless cycle of churning patients to cover their overhead expenses. There are built-in incentives in the reimbursement models with all of the major insurance companies, Medicare, Medicaid, and all financial reimbursement programs in the United States to provide a less personal and lower quality of care to see more patients, faster. The result is patients who do not know their healthcare providers, doctors who take weeks or months to get into, missed phone calls, outrageous expenses, and ultimately a poor healthcare experience. The loss of the provider-patient relationship has let loose an age of mistrust in medicine and healthcare that must be addressed.Direct Primary Care, by contrast, is a fundamental change in the �usiness of medicine.  That's all it truly is, you change the business and financial backbone of how it works at a foundational level, and it will then change how the medicine can be delivered. Change the pricing structure, you change the medicine.  To illustrate how this works is easy. In the fee-for-service model when you take into account the overhead expenses, the salary of staff, the salary of the doctor, and the reimbursement rates of insurance: we build in a markup into every service that gets performed to account for that.  Once you know how much you can make per service there becomes a quota of how many services a day a doctor must perform for a practice to remain profitable. On average, in the United States, the typical provider must see between 25 to 30 patients per day. To maintain this volume of 25 to 30 patients per day, every day, most providers in the United States are therefore responsible for between 2000 to 3000 patients on their entire panel. Providers who have less than 2000 patients, usually cannot sustain the 25 to 30 patient volume each day and are therefore unable to sustain a successful practice. The reason that providers must see between 25 to 30 patients in the day is because of the actual reimbursement schedule from the insurance companies. Doctors and providers who are in an insurance network are mandated to accept the pricing schedule provided by the insurance company or they will be kicked out of the network. Additionally, the pricing schedule is to be provided practice-wide and cannot be adjusted if there is a self-pay patient without insurance. By doing simple math, to see 25 to 30 patients in the day that usually means a provider must see a patient every 15 minutes. So if you've ever wondered to yourself why your doctor is so busy, why can you only be seen for 15 minutes, why you haven't heard back from them, or any other concern about how busy your doctor is – this is why.  This effect becomes even more pronounced with providers who take Medicare, Medicaid, and other federally insured patients.  While they are great on the patient's side with low premiums and deductibles, the actual reimbursement rates for providers are substantially lower than their private insurance counterparts, thus requiring even more volume to make up those fees.  This is why 1/3 of patients on Medicare and Medicaid nationwide cant even find a provider who will accept them.Direct Primary Care attempts to address these problems by separating the income of the practice from the services that are provided. This simple technique is not new.  It's the same model that has been used for gym memberships, Netflix subscriptions, and a variety of other subscription-based services that allow you to use your membership whenever you need to and as much as you want to.  This simple change from fee-for-service to a membership-based program has long-reaching effects.  First, there is no limit on how many times you can be seen and there is no �isit fee or copay.   Additionally, while most practices will still charge for certain procedures that require consumable supplies, all of them offer extreme discounts with a membership compared to an insurance-based practice.  At Starlight Health, we've taken it a step further and the only extra charge is for consumable inventory supplies if they are used.  That’s it.  When paying us directly, It is not required for us to charge the insurance rates for our services and instead we can set our pricing structure as we see fit.  A typical markup at Starlight Health is less than one dollar to cover transaction fees which is a mere fraction of the typical retail rate. For example, routine blood work with our practice which would typically cost a patient over $400, cost Starlight health members $16. These kinds of savings are seen across the board regardless of what we do and have resulted in patients saving thousands of dollars each year without even having to touch their insurance or deductible.  This has created an effect known as stabilization of expenses which can help to create a budgetable and predictable expense for healthcare throughout the year.

Within the current discussion and nomenclature surrounding the product, there is little to no differentiation or coherent brand identity. There is no standard for a "premium" concierge offering nor is there a clear "entry level" version. In fact, there is little product development or marketing outside of broad, generic themes. As the industry grows, however, these types of distinctions will become more and more apparent and dichotomies will evolve.

Is Direct Primary Care Worth It?Many people these days have never heard of Direct Primary Care, till now it's a model that has gone mostly unnoticed and in the public eye may just be a fad. This could not be further from the truth, however. So the question is, is Direct Primary Care worth it? I would say that the answer is without a doubt, yes. Before we can go into why it's worth it, it is important to understand what it is and how it works. In a very simplistic form, Direct Primary Care works by separating the income for a medical practice from the services that are provided.  That’s really all it is!  This simple mechanism is what allows a practice to stabilize their income regardless of how many services are provided and has a wide array of implications. This means that it doesn't matter how many patients a provider sees in a day, it doesn't matter how many times a patient comes to the office, it doesn't matter if they called or texted, it doesn't matter if they received procedures or various other services - the income for the practice is the same. In Direct Primary Care, we utilize a monthly membership plan and then can offer our services at drastically reduced prices.  Some Direct Primary Care practices offer their services at no cost, some at discounted prices, at Starlight Health we only charge for the cost of inventory and materials used during your treatment with no additional markup.  For those that are unaware, this type of billing mechanism is not possible in the traditional fee-for-service model. In the traditional system, built into the pricing structure of every service and procedure that is done includes all of the marked-up costs and overhead expenses associated with it.  Because of that, on average there is an approximately 3000% markup for every service that is provided above the cost of materials to treat you. But with a Direct Primary Care membership, that markup is fixed to a single monthly fee and does not change no matter how much care is provided. This is how patients can stabilize the healthcare expenses for an entire year and drastically reduce the total expense they would've paid during that time. Additionally, since the membership pays the salary of your healthcare provider and there is typically no extra cost to see them, sometimes a visit may not even be required and a simple text message is all that is needed! (Yes you read that correctly, if we don’t have to bill you for a visit, then a text message may be all that is required!) It also becomes much easier to see them for preventative measures and maintenance checkups than what could've otherwise been afforded. Members of Direct Primary Care programs across the nation are finding that increased access, time with their provider, preventative health screenings, and education about important healthcare concepts is leading to healthier lives and lower costs.

At the current state of our understanding of COVID-19 patients are dying from a variety of effects. COVID-19 has been found to cause respiratory failure, organ failure, blood clots, and a host of other effects. The exact mechanism in which it is doing this is not known and therefore the best way to treat and prevent it is likewise either unknown or currently not possible.

What is Direct Primary Care?What is Direct Primary Care? It's a simple enough answer with incredible changes and results. In its basic form, Direct Primary Care is when patients contract directly with a healthcare provider. That's right, I do not mean contracting with an insurance agency, I do not mean being assigned a doctor, I do not mean being forced to be in a network and getting bounced from one doctor to the next in an endless battle of who's going to deal with you. Direct Primary Care is you picking your provider, contracting with them directly, end of story.So why does this matter? How much of a difference could it really make to contract directly with a doctor instead of by using insurance? The answer is... A lot. The difference Is profound, not just financially, but in the quality of care you receive. The traditional healthcare system works on a concept known as fee-for-service. This is a concept that has been around for generations, ever since the inception of modern medicine and has served us well in the past.  Over time though as various entities have become involved, as the prices have skyrocketed, and as the volume of patients has increased.. the fee-for-service model has become outdated and has become a source of many of the problems rampant today. Because of how the �usiness of medicine has become structured, doctors and healthcare providers are now forced to see more patients in the day, spend less time with them, and perform in an endless cycle of churning patients to cover their overhead expenses. There are built-in incentives in the reimbursement models with all of the major insurance companies, Medicare, Medicaid, and all financial reimbursement programs in the United States to provide a less personal and lower quality of care to see more patients, faster. The result is patients who do not know their healthcare providers, doctors who take weeks or months to get into, missed phone calls, outrageous expenses, and ultimately a poor healthcare experience. The loss of the provider-patient relationship has let loose an age of mistrust in medicine and healthcare that must be addressed.Direct Primary Care, by contrast, is a fundamental change in the �usiness of medicine.  That's all it truly is, you change the business and financial backbone of how it works at a foundational level, and it will then change how the medicine can be delivered. Change the pricing structure, you change the medicine.  To illustrate how this works is easy. In the fee-for-service model when you take into account the overhead expenses, the salary of staff, the salary of the doctor, and the reimbursement rates of insurance: we build in a markup into every service that gets performed to account for that.  Once you know how much you can make per service there becomes a quota of how many services a day a doctor must perform for a practice to remain profitable. On average, in the United States, the typical provider must see between 25 to 30 patients per day. To maintain this volume of 25 to 30 patients per day, every day, most providers in the United States are therefore responsible for between 2000 to 3000 patients on their entire panel. Providers who have less than 2000 patients, usually cannot sustain the 25 to 30 patient volume each day and are therefore unable to sustain a successful practice. The reason that providers must see between 25 to 30 patients in the day is because of the actual reimbursement schedule from the insurance companies. Doctors and providers who are in an insurance network are mandated to accept the pricing schedule provided by the insurance company or they will be kicked out of the network. Additionally, the pricing schedule is to be provided practice-wide and cannot be adjusted if there is a self-pay patient without insurance. By doing simple math, to see 25 to 30 patients in the day that usually means a provider must see a patient every 15 minutes. So if you've ever wondered to yourself why your doctor is so busy, why can you only be seen for 15 minutes, why you haven't heard back from them, or any other concern about how busy your doctor is – this is why.  This effect becomes even more pronounced with providers who take Medicare, Medicaid, and other federally insured patients.  While they are great on the patient's side with low premiums and deductibles, the actual reimbursement rates for providers are substantially lower than their private insurance counterparts, thus requiring even more volume to make up those fees.  This is why 1/3 of patients on Medicare and Medicaid nationwide cant even find a provider who will accept them.Direct Primary Care attempts to address these problems by separating the income of the practice from the services that are provided. This simple technique is not new.  It's the same model that has been used for gym memberships, Netflix subscriptions, and a variety of other subscription-based services that allow you to use your membership whenever you need to and as much as you want to.  This simple change from fee-for-service to a membership-based program has long-reaching effects.  First, there is no limit on how many times you can be seen and there is no �isit fee or copay.   Additionally, while most practices will still charge for certain procedures that require consumable supplies, all of them offer extreme discounts with a membership compared to an insurance-based practice.  At Starlight Health, we've taken it a step further and the only extra charge is for consumable inventory supplies if they are used.  That’s it.  When paying us directly, It is not required for us to charge the insurance rates for our services and instead we can set our pricing structure as we see fit.  A typical markup at Starlight Health is less than one dollar to cover transaction fees which is a mere fraction of the typical retail rate. For example, routine blood work with our practice which would typically cost a patient over $400, cost Starlight health members $16. These kinds of savings are seen across the board regardless of what we do and have resulted in patients saving thousands of dollars each year without even having to touch their insurance or deductible.  This has created an effect known as stabilization of expenses which can help to create a budgetable and predictable expense for healthcare throughout the year.

Falling Through the CracksA few generations ago, it was commonplace that when going to your local family physician it was easy for them to be the captain of the ship.  They would tell you what's going on, what you needed to do, and that would be that.  We could trust that our physicians had everything in hand.  Over time, healthcare has become more complicated and the relationships that we providers have with our patients have become obscured, degraded, and lost.  The fact remains that in today's medical landscape, providers have become overburdened by too many patients and it has become impossible for us to keep up with each patient. Because of this, patients who are accustomed to the old ways of doing things are falling through the cracks.  Lab results have gone missing, patients never hearing back from their providers, some patients forget that they were supposed to follow up, some thought that “no news was good news” and assumed everything was fine.  The truth is, everything is not fine.  The traditional system has too many entities, too many complex systems and too many failure points.  We’ve had x-rays that were never sent to us from imaging facilities, human errors, glitches with EMR systems, patients who changed phones numbers and a multitude of other reasons that complicated our care.   The healthcare system has become so convoluted that it is no longer safe for patients to assume that your healthcare provider has everything in hand.  It has become increasingly important that patients play a more active role by becoming well informed, educated, and personally involved in their medical decisions.  With soo many patients, and so few providers, if you want good health care the truth is, you (the patient) need to be actively involvedSHARED DECISION MAKINGThe overloaded system has not gone unnoticed to medical schools these days.  Every attempt is being made to improve the quality of care and one of them begins by making the patient more involved.  The modern medical system has begun teaching new providers about a concept known as Shared decision making.  If you've never heard this term before, it essentially means that it is no longer the job of your provider to ell you what to do (though sometimes that is appropriate) but is instead usually our job to educate you on the options and to help you decide on what is best for you.  We recognize that one size does not fit all.  Your preferences, beliefs, and desires for your health are important factors that you need to bring to the table.  Finding a provider who has similar beliefs to you and how you approach your health is a good first step to build rapport.  Once you have a provider you can trust it becomes easier to become more involved as there is no relationship without trust.  The goal is that you are actively involved in the process, aware of what is going on so you, and your provider, can come to mutual decisions together.It is, unfortunately, all too common for patients to either A) rollover and blindly do what they're told, or B) Ignore a plan because they didn’t like it.  You need to be advocating for yourself,  you need to be asking questions if you do not understand what is going on.  You need to give your opinions a voice so that you and your provider can come to an understanding.  Your provider is not a mind reader!  If you walk out of a visit with your provider without voicing your dissent to a care plan or have no intention of following through with it, then the time you and your provider spent together was, unfortunately, a waste.  In the age of “cancel” culture where we will often just quit and go to a new provider, it can be more beneficial for you in the long run to voice your concerns and come to a mutual understanding rather than just quitting.  Be involved, be present, and help your provider come to a “shared decision”SH_PatientAdvocate_smallsize.pngTHE PATIENT ADVOCATEIt is your job as a patient to make sure someone knows in-depth about what is going on with you.  What problems you have, what things you are at risk for, what you need to improve.  They should know what medications you’re on, what dosages, when your appointments are...  Everything about your health should be under control.  The person who does all of this is known as a Patient Advocate.  This could be a family member, a friend, a spouse, a nurse, or a variety of other people but for most patients, the best (or only) Patient Advocate you will ever get is yourself.  If you are not able to advocate for yourself to manage all of your own needs, then who will advocate for you?  The patients who do not have someone able to handle their needs are the ones who usually wind up with major issues down the road that could have been avoided.QUESTIONS TO ASK YOURSELFTake this time to think about what aspects of your care are you truly knowledgeable about and what are you not?Am I truly able to advocate for myself?Has my healthcare provider communicated with me everything they are doing?  Is there anything I don’t understand and should be asking questions?Do I have a list of all of the healthcare providers that I see?Do I know all of their phone numbers and fax numbers?Do I know their addresses?Do I know how long their office typically books out?Do I have follow up appointments scheduled with them?Do I have any labs due before I see my providers?Do I have any medications that might run out before my appointment?Do I know what my medical history is?Do I know my family history?Do I have documentation of these and could readily provide them to a new Provider?Do I have all my immunization records?Do I know when I’m due for my screenings?Do I know what disorders I’m at risk for (due to personal or family history)?Am I taking steps to address my risk factors? Why not?etc.. etc.. etc…I know how quickly all these questions can add up and how quickly they can overwhelm.  But they are important to ask and be well managed for patients long term health.  When providers are seeing thousands of patients the endless array of questions become harder and harder and patients fall through the cracks more and more.  I don’t want that to happen to you, and the first thing you can do is to work on changing your mindset.  Treat the healthcare system like you would driving a car and practice “defensive driving”.  You should assume that everyone on the road has no idea how to drive and accidents do happen.  You can protect yourself by being informed, being involved and making sure you, or someone else, is always advocating for you.  Find yourself a provider you can trust, voice your opinion, and be mindful of the broken system.

Family Practice Physicians typically offer a family plan where dependent children up to a certain age are covered free. Internal Medicine Physicians may offer a similar program but typically for dependent children between the ages of 16 and 25. Therefore there are many single moms joining these practices.

Direct Primary Care or Concierge Medicine. What Business Model Is Best For Me?Many doctors have chosen to partner with large franchise concierge medicine businesses to help with the startup and transition needs necessary to open their concierge medicine practice. However, more than half of all concierge physicians have opted to use accountants, attorney's, practice managers and business consultants to navigate their way into the new practice model. As more and more doctors begin to analyze and potentially move into concierge medical practices, independent physicians choosing not to be a part of a large franchise operation instead are transitioning with a smaller consultant should examine their fee structure and price them competitively.A private consultant specializing in Direct Primary Care models says he performs a thorough analysis of the practice and determine areas where expenses will be reduced. After a survey of the physicians patients, he conducts a 12-16 week conversion. Fees are collected during the transition only. Once a successful conversion has been completed, he helps to train the physician staff to provide membership services. If customer service is maintained, he knows the practice will continue growing without a need for further services.Most doctors currently practicing concierge medicine as a career choice fall into one of two intelligence-gathering categories when they first opened. First, they used a franchise concierge company to help them with the details or they opted to do it themselves and surround themselves with a local team that would provide counsel in starting this practice model.The Collective found over the past four years that concierge doctors operating under the direction of a large franchise concierge company or consultancy will price services, on average, between $1,200 and $1,800 per patient and opening with a patient load between 300-750 patients. This helps the practice compete with local retail clinics, pharmacy chains, primary care doc-in-a-box practices and attract, en masse, the demographic that practice needs in order to succeed in their local market. They also found that many independent concierge doctors who chose not to operate under the guidance of a franchise business model were charging much more for their services, between $2,500 - $5,000 per patient, and opening with a patient load of 75-180 patients under their care.The premise of most franchise concierge medicine business models, termed Fee For Non-Covered Services Model, reduces the size of a medical practice to a more manageable patient load and these patients agree to pay a fee for more time with their physician, an annual physical, and more personalized access and service. Emphasis is on a healthier lifestyle, both for the members and the physician. According to a national poll of concierge doctors from 2010-2012, approximately 80% of these practices accept most major insurance plans and participate in Medicare.The Fee For Non-Covered Services Model allows for Medicare and private insurance to be billed by the physician for routine visits and procedures. To date, this model comprises the largest segment of the market, approximately 46 states, although Direct Primary Care (Fee For Care Model), is rapidly catching up in select markets, according to The Collective.Distinct advantages for selecting the FNCS model are:Physicians who are looking to slow down without affecting their current income levels will find this model attractive. These types of models offer an enhanced physical (or some enhanced procedure or procedures not covered by Medicare), on an annual basis, which is the basis for the entire fee. Fees for these models usually range from $1,200 - $2,000. It is critical that physician converting to this business model are able to reduce expenses to accommodate this type of practice.There is typically a maximum number of patients allowed to join the practice, usually around 600. Industry sources report that they have not seen too many of these concierge medicine practices reach the 600 patient-member level, but that most are satisfied at the 400 patient-member level.Contrary to what people think, this model is not just for the rich as the vast majority of patients make less than $100K, according to industry surveys. The concierge medicine industry has been touted by the media and television for years as an expensive way to see the doctor you've known for years. At the inception of the movement in the early to mid-'90's, this was factually true. What's not truthful is that nearly two decades later, the majority of concierge medicine and direct primary care clinics cost their patients between $50 - $135 per month.Family Practice Physicians typically offer a family plan where dependent children up to a certain age are covered free. Internal Medicine Physicians may offer a similar program but typically for dependent children between the ages of 16 and 25. Therefore there are many single moms joining these practices.There are many development teams and implementation companies that are helping physicians to convert to these more price transparent business models. They have every base covered with regards to ensuring a successful launch. There is nobody in this industry that does it better. There is a very high failure rate for physicians trying to transition to this type of model on their own. The conversion process is intense and every transition has its own unique challenges.Distinct disadvantages for selecting the FNCS model are:The FNCS business model works very well when implemented appropriately. Although a medical practice is considerably smaller and much easier to manage, there are still existing issues with regards to billing Medicare and insurance companies, collecting co-pays, checking patients in and out, etc. This not only increases operational costs, but most of the problems surround billing insurance. Alternatively, in other concierge and direct primary business models, operational costs are much lower because the physicians/practice do not participate in Medicare or insurance plans. More about the pros and cons of this in Part 2 of our follow-up article.FNCS Business Models require that the services paid for by members are not Medicare covered services. Accordingly, it is critical to have legal input with regard to structuring this model. Because Medicare regulations are likely to change frequently, especially with the healthcare reform act recently signed into law, ongoing legal monitoring is necessary in this type of model.

In my own life, I wasn’t always in medicine. I grew up wanting to be an aerospace engineer and an astronaut. I wanted to build space shuttles and travel to the moon. I had a whole life plan on how I was going to do that too! But life it seems... had other plans for me. In college I got bounced from one doctor to the next for nearly a year, never spending more than 10 minutes with any of them. No one had the time to sit down and just listen to me until finally, one did. Early 2007 after being bounced to over 15 different doctors - one single provider, a physician assistant I’d been turfed to sat down and just listened to me. There were of course patients waiting behind me but she let them wait and took the time anyway to just listen to my story from start to finish. Concerned by what she heard she ordered an MRI and soon after a diagnosis was made and one final referral was in the works. Within a month I was scheduled for my first life-changing surgery and never looked back. All it took was one, one person that had made the time to sit and listen that changed my life. It doesn’t matter if it’s a doctor, a specialist, a physician assistant, a nurse practitioner, a counselor, a family member, or a friend. The ones who make the biggest impacts in our lives are the ones who actually care and listen. I choose DPC so I can be like that PA who listened to me. I choose DPC so the patients who now see me will always know I’m available to listen when they need it.

Why Choose Direct Primary Care?There is a lot that can be said about Direct Primary Care (DPC). To keep it short and simple, we choose DPC because it is a solution. A solution to a problem that has been festering in healthcare for generations. Rampant and exorbitant costs, outrageous bills, overloaded providers, healthcare systems that take ages to get in to. The breakdown of the “doctor-patient relationship”. It’s a system that is headed towards collapse. In its current form, it’s unsustainable. Patients are unhappy, providers are unhappy, the whole system is a mess.But why? How did we get this way? Surely, it wasn’t always like this, was it?The truth is that over the last century a multitude of changes has occurred that has caused a constant evolution in the healthcare landscape for both good and ill. People will often state that a hundred years ago medicine didn’t cost what it does today. While that’s completely true, it’s not exactly the entire story. In the early 1900s, medicine was still kind of in its infancy. There weren’t standardized training programs, the skills of doctors varied wildly from physician to physician. Hospitals were in their infancy and sophisticated diagnostic imaging such as X-rays, CT scans, MRI’s, as well as the complex procedures that are available today just didn’t exist. The standard of care and technology in today’s medical landscape has advanced to levels that were unheard of a hundred years ago or even 50 years ago! Unfortunately with sophistication, comes the costs associated with it. In response to these changes, health insurance was developed in an attempt to make medicine more affordable. Hospitals began to contract with patients and employers to protect them from catastrophic illnesses and over time it became a normal benefit for employees across the nation. Over the years though, the original intentions of insurance have become obscured. The goal of protecting patients against catastrophic costs was so financially successful that other parties became involved and further profit-driven policies were developed to maximize revenue. Over time, Insurances enrolled physicians and hospitals to form networks that only their members could see. Insurances began creating their own system for how to manage patients that makes them the most money and pays out the least. Insurance became a business and along the way one of the most precious commodities, the doctor-patient relationship was lost. Today, many of the Fortune 500 most profitable companies are medical companies. It’s not just insurance companies however, price managers, distributors, and various other entities have gradually stuck their hand in the pot bloating the system little by little. Once lobbyists and politicians got involved with regulations and mandates we finally arrive at the mess we have created for ourselves today. At some point, the whole thing became rigged so that costs were so outrageously expensive and inconvenient that you just couldn’t get good care without health insurance.As the insurance companies changed their billing practices to maximize profits they began developing what's known as “managed care”. They decided who and what they would pay for making the decisions of the providers and patients more and more irrelevant. After all, what good is it to have your doctor tell you that you need an MRI if your insurance won't approve it? Those providers who spent time with their patients, who got to know each person who walked through their door, who came to your home and who knew you and your family by name were either bought out or forced out. The practice of sitting down with a patient for an hour led to empty wallets and closing practices. Unable to keep up, they were replaced by those who could see more patients, faster, in the way the insurance companies demanded. The result is what has become the standard today: providers who don’t know you, whom it takes you weeks to get in to see, who you have to wait for an hour in the waiting room for, who you finally saw for 5 minutes before they rushed out the door and one who if you got a new job or new insurance you may lose and have to start over with someone else “in-network”. Honestly, this system is not why any of us got into medicine. None of us chose this profession so we could rush from room to room only to forget our patient’s names and come home after 16 hours exhausted. We didn’t get into medicine to memorize billing codes and watch the clock to know how much to charge you. We get into medicine to help and to heal, but the model of business thrust upon us to achieve that has become flawed and broken. There’s a reason burnout is rampant across medical providers (some studies estimate a nearly 30-50% burnout rate), suicide rates are way higher than the general population and it’s only getting worse. On average, each provider is having patient panel sizes that are orders of magnitude larger than any sane person could handle.Now don’t get me wrong, health insurance serves a purpose. Innovation and evolution are a natural part of the history of healthcare and insurance is one of them. It is not inherently evil and despite all I’ve written so far I’m not against health insurance. Advances in medicine and specialist procedures ARE expensive. That MRI machine at your local hospital or brand new Da Vinci surgical robot that cost over 2 million dollars to acquire does not just pay for itself! Even I have my own insurance plan to protect me and I recommend everyone have something to protect them from catastrophic costs. The problem is how far the system has strayed from its purpose. It has migrated away from catastrophic costs into the arena of general everyday care and prices have skyrocketed because of it.  Most homeowners have insurance to protect them against a fire, flood or other major damage to their home but most do not use their insurance to paint the walls and fix the toilet.  The system has bloated so far today that the average person is paying more in health insurance than they do for actual health care. The average premium in the United States is $440 per month ($5,280 per year), with on average over $4500 deductible. Meaning on average, most Americans would need to pay nearly $10,000 PER YEAR before their health care costs are covered. Some may even have co-insurance beyond that. These costs drive many patients to forego insurance altogether and choosing to avoid visits to their providers, avoiding checkups and care regardless of their medical history. There is a way that we can co-exist but the current profit-driven system that dominates healthcare right now isn’t it.So back to the original question, why choose Direct Primary Care? We choose DPC because it is a way that we can cut through the mess that healthcare has become. Simplifying care into something that makes sense and is more affordable. It’s not perfect and there are roadblocks at every step of the way... but we choose it anyway. We choose it because DPC is how patients get a provider in their lives that they can get to know and trust no matter which insurance they have. We choose it because DPC is how when you fall asleep tonight you can rest easy knowing that if your child wakes up with a fever in the morning your provider will be there to answer your call. We choose it because DPC is how when you go get your blood drawn this week you realize you can actually afford it. We choose it because DPC is how when you were sick with cancer and had to see the specialist, your provider went with you. We choose it because DPC is how we rebuild the provider-patient relationship.In my own life, I wasn’t always in medicine. I grew up wanting to be an aerospace engineer and an astronaut. I wanted to build space shuttles and travel to the moon. I had a whole life plan on how I was going to do that too! But life it seems... had other plans for me. In college I got bounced from one doctor to the next for nearly a year, never spending more than 10 minutes with any of them. No one had the time to sit down and just listen to me until finally, one did. Early 2007 after being bounced to over 15 different doctors - one single provider, a physician assistant I’d been turfed to sat down and just listened to me. There were of course patients waiting behind me but she let them wait and took the time anyway to just listen to my story from start to finish. Concerned by what she heard she ordered an MRI and soon after a diagnosis was made and one final referral was in the works. Within a month I was scheduled for my first life-changing surgery and never looked back. All it took was one, one person that had made the time to sit and listen that changed my life. It doesn’t matter if it’s a doctor, a specialist, a physician assistant, a nurse practitioner, a counselor, a family member, or a friend. The ones who make the biggest impacts in our lives are the ones who actually care and listen. I choose DPC so I can be like that PA who listened to me. I choose DPC so the patients who now see me will always know I’m available to listen when they need it.If you’re here reading this, chances are you know there is something seriously wrong with our healthcare system. It’s messy, it’s bloated, and there are uncountable entities all driving the system to become more and more expensive. If you’re reading this then you also know that to fix it, there’s so much more to it than just slapping a Medicare for all sticker on it and giving the same broken system to everyone. In life, it is often the case that the best solutions are the ones that are outside of the box. DPC offers a novel way to untangle at least some of the mess that healthcare has become. I choose DPC because I believe there is a better way to make a difference in the lives of my patients.