by Jordan Roberts
Director of Government Affairs, John Locke Foundation
Modern America has a craving for goods and services that are supplied instantaneously. If we want food, we order it, and it is brought to our doors with Uber eats. If we want television or movie entertainment, we can stream anything we want directly to our televisions with streaming services such as Netflix. If we want a product without going to the store, Amazon can ship it, sometimes the same day the order is placed. To keep up with the increased demand for services, industries must face the innovation challenge head-on. The millennial generation, those of us born between the early 1980s and the mid-1990s, is one of the main contributors to the growing desire to have products on-demand. This “on-demand” attitude has led many industries to adjust to this new reality. Among many other norms, millennials have been accused of killing the 9-5 workday, the dinner date, and even the napkin industry. Could millennials next target be primary care doctors? Emerging trends in providing primary care suggest that they are. But for once, millennials may end up contributing to needed innovation in the primary care sector through their “on-demand” mentality.
While it may seem that comprehensive health insurance is the only vehicle for good health care, this may not be the case anymore. Millennials and many others are not using the traditional model of seeking primary care using their health insurance. Instead, we see a new wave of innovative approaches to primary care coverage that cost much less. In the space below I describe some of the new ways that people are receiving primary care.
Dissatisfaction with the way that the traditional health insurance model works is a contributing factor to the primary care evolution. According to a recent survey done by the American Customer Satisfaction Index, customer satisfaction with the top insurance companies decreased. This is mostly attributed to the complex process and billing procedures that occur when a patient uses traditional insurance. The survey revealed that the easiest way for health insurers to make gains in satisfaction would be to make the process of understanding insurance statements easier and improving the experience when customers interact with a call center to ask questions about claims. Retail clinics, urgent care, telemedicine, and direct primary care are innovative ways to get primary care that largely take the difficulty associated with insurance out of the equation and open up access to affordable health care.
Urgent care is probably a fairly familiar concept to most Americans. An urgent care facility provides care outside of the traditional doctor’s office and can offer cost-effective ways to treat serious ailments on-demand. Urgent care visits have spiked in recent years, growing to 15,300 patients annually or an average of 294 patients a week. These clinics stay open late and often are conveniently located for individuals who need the care to get the services they need with considerably lower out-of-pocket costs. The physicians that work in these facilities can treat a wide range of issues, and the facilities can act as a substitute for many emergency rooms visits, which is one of the costliest forms of care.
Retail clinics, such as CVS Minute Clinic, provide many primary care services and operate in a retail store. These types of clinics cannot treat all of the issues that are treated in an urgent care setting. However, they can treat many conditions that would have otherwise been addressed in a primary care setting. Retail clinics usually only staff nurse practitioners and physicians, who perform some of the same duties as primary care doctors. Retail clinics usually have set prices for services for preventative care and give patients a lower cost source for small procedures that might have otherwise gone untreated.
Telemedicine is the “use of technology to deliver health care, health information, or health education at a distance.” Given how widespread the use of mobile technology is used in present times, it’s easy to see how the use of technology to deliver health care services at a distance is very appealing. Telemedicine allows a patient to see a physician remotely from anywhere. The cost of each visit is almost always less than what you would pay to see a traditional physician. Also, the on-demand model of telemedicine usually allows a patient to connect instantly with a physician to discuss medical needs rather than going and waiting in a doctor’s office.
Direct Primary Care
Sometimes direct primary care is thought of as a retail clinic, but in reality, it is very different. Direct primary care practices work like a gym membership. In exchange for a monthly fee, the patient receives around-the-clock access to primary care services from their physician. The traditional primary care doctor-patient relationship has diminished over time because primary care doctors have to comply with an enormous amount of regulation and complete insurance paperwork. To promote that relationship, which is one of the most important aspects of staying healthy, the direct primary care option throws out the traditional insurance model altogether. When doctors are free from complex insurance billing and excessive regulations, they focus on their actual job – caring for patients. Many direct primary care doctors and patients who use this service are very satisfied with the ease and the health outcomes they receive from this innovative way of offering primary care.
All of the unique options described above are results of the changing way in which the American health system’s approach is providing primary care. The traditional primary care and health insurance model is losing favorability. There is such an enormous amount of time and effort that goes into complying with all of the insurance requirements and regulations that it diminishes the relationship between the patient and the physician. When this relationship suffers, it drives up costs while decreasing good health outcomes. Patients are demanding more on-demand care in the form of retail clinics, urgent care, telemedicine, and direct primary care. Millennials are certainly one group that is driving this trend, but the overall trend, I believe, is the result of the breakdown of the traditional primary care doctor and the relationship with the patient. These forms of primary care that do not use the traditional primary care model are quickly becoming substitutes that offer greater access, lower cost care, and equal outcomes to those that patients receive at a traditional primary care doctor.