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Are Primary Care Doctors Being Replaced By Urgent Care?

Posted by Lawrence Kerr on Wed, Apr 11, 2018 @ 06:01 AM

filip-mroz-172352-unsplashThe time when each family had a family doctor isn’t long behind us.

When my parents were growing up, it was common for the family doctor to know your parents, kids, cousins, and neighbors; to make house calls; and to take your full situation (social, economic, cultural, familial) into consideration in treatment. Of course, payment might be made in dollars, insurance, or chicken eggs.

That time in medicine, of course, is gone. While some elements of this system are having a rebirth (like the dawn of the concierge family doctor), the structures that supported it have crumbled.

Until recently, though, primary care doctors have been a core part of the healthcare system, and the foundation of most people's experience as patients. Primary care doctors, of course: 

  • Give continuity of care, remembering your last visit and your overall life situation, embedding their perspective in these elements 
  • Coordinate care, playing the role as the key intersection point among specialists and family and patient.
  • Tend to have long-term incentives, meaning their motivation is usually providing the right care over the long term, not necessarily providing a quick fix. 

Recently, as the New York Times investigates, urgent care and "minute clinics" have begun to supersede primary care doctors as the first place people go when they need medical care. There are 12,000 across the country and as visits increase, visits to primary care doctors have dropped. There are multiple factors that contribute to this, including the key advantages of urgent care or retail clinics: 

  • Expanded office hours, which often coincide with hours that busy working people are available.
  • Affordable, clear fees.
  • Perception of faster results and more streamlined treatment. 

There certainly is no replacement for a caring doctor who can truly care for you and understand the context of what you’re going through. Many in the healthcare field worry that outcomes will be worse from urgent care approaches, that antibiotics may be prescribed unnecessarily, and that key conditions or issues may be missed. Plus, fast isn’t always better — or cheaper. “None of the research has shown any of these approaches to delivering care has meaningfully addressed cost,” Dr. Werner said in the New York Times.

That said, even the best primary care doctor doesn’t eliminate the need for excellent care coordination and healthcare collaboration. For many years, the primary care doctor seemed like the panacea for coordinated, thoughtful care. But in reality, so much has fallen through the cracks for so long. And overloaded providers struggle to do healthcare collaboration and care coordination in the right ways. 

So much is lost when we transition from primary care doctors to urgent care clinics. But something might be gained as well. Perhaps, as the traditional structures of healthcare change, doctors and patients may begin to be more open to new solutions. Demands for speed and efficiency are exposing the weaknesses of the old system, certainly -- it's up to us whether we rise to the occasion and create better things to replace what's no longer possible to depend on. 


For more stories of how people are using telemedicine to move forward in healthcare, download our quick guide: 

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Tags: direct primary care, care coordination, emergency medicine, healthcare collaboration software

Why New Providers Are Choosing Concierge Medicine

Posted by Lawrence Kerr on Sun, Dec 15, 2013 @ 08:16 AM

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This month, we've been covering the direct care/payment model of medicine -- termed "concierge medicine" or "direct primary care." You can see our overview here and our discussion of models for middle and lower-income folks here.

One trend in this direct care movement is that new providers are among the most common providers advancing the model, particularly in the form of the more economical "direct primary care." As healthcare providers who have been practicing for decades, we certainly aren't in the ranks of new providers! But we're noticing some interesting folks from the next generation -- providers like:

So, one question is, why are new providers the ones at the front lines of the concierge / direct primary care model? There are a number of explanations for the phenomenon, but we think that a few things are particularly interesting causes to notice:

  • Technology. Even over the last few years, we've seen the cost and hassle of technologies plummet. New providers are in an ideal location to take advantage of that trend -- and may be more accustomed to these technologies being a part of their workday than other providers.
  • Cultural context. The new generation across all industries is having to reinvent things -- whether it's publishing, finance, or medicine. Additionally, the alternatives are worse for new providers than they were several decades ago. Healthcare provider burnout is skyrocketing. New providers in the system know that -- and are taking the steps to avoid it. 
  • Idealism. Our observation is that several decades ago, most new providers went into medicine for idealistic reasons. As incomes went up, some folks started entering for less altruistic motives. But in the last several years, perhaps as medicine has become more difficult of a field, we again notice the majority of new providers doing the work out of idealism. New providers want to spend their time with patients, not with insurance companies. And we notice that many direct primary care providers share this kind of do-the-right-thing ethic -- finding the model makes it easier to do medicine in the ways they want to.
  • Networks. New providers, often in urban or progressive areas, seem to have patients that are willing to try something new. This means that as a doctor makes a change to a new model, they may be able to take their old patients with them. 

Concierge medicine and direct primary care are just two of the ways that providers are changing healthcare through their innovation. There is no one right answer, but we certainly support the many approaches that providers are experimenting with. And we think that all providers could learn a thing or two from our younger counterparts in this type of experimentation and the success it's having.

We also believe that medical collaboration is fundamental to these innovative models that are improving care, helping with healthcare provider burnout, upping patient satisfaction, and cutting costs.


Get our medical collaboration tips here:


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Tags: direct primary care, telemedicine, provider burnout, good medicine, concierge medicine

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