John Locke Update / Research Newsletter

The Many Flavors of Direct Primary Care

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Tired of the average 7-minute doctor visit? Then consider making the switch to direct primary care (DPC). For an affordable monthly payment, patients are granted around-the-clock care, and doctors can spend more time with their patients. They can make house calls. They can dispense prescription medications in-office.

The list goes on….  

One of the best things about DPC is that it comes in a variety of flavors. Solo practitioners operate their own DPC establishments. Others practice under a hybrid model, in which a physician group accepts insurance and also delivers basic health care without the middleman. Others cater to large self-insured employers (both private and public) as a preventative health care benefit option for their workers.

And then there is St. Joseph Primary Care, a Catholic direct care clinic located in Raleigh. Founded in August 2014 by executive director Peter Le and his wife, Dr. Trinh, the nonprofit believes that sustaining improved health outcomes for patients is a combination of more time spent with the doctor and tapping into one’s faith in God.

Mr. Le explains that patients’ quarterly or annual membership fees help to offset the cost of charitable care provided to members unable to pay. One can consider the clinic to operate under a "Good Samaritan" model, whereas big government programs like Obamacare are more like Robin Hood, stealing from the rich to give to the poor.

Through St. Joseph Primary Care, patients (also known as benefactors) willingly contribute portions of their annual membership fee to help those less fortunate. Say, for example, a benefactor pays his or her annual $500 fee upfront, but only visits the clinic for a comprehensive physical and a few basic lab tests. Unused portions of the benefactor’s membership can then be claimed as a tax-deductible donation because St. Joseph Primary Care is a federally registered tax-exempt organization and uses those leftover funds for charitable care.

How’s that for taking comfort in knowing that patients struggling to afford basic health services are benefiting from the same superior level of health care as paying members.

To date, the Good Samaritan values St. Joseph Primary Care lives by are a self-sustaining success. The clinic relies on word of mouth advertising primarily through the Catholic Church and the patients, since an overwhelming majority of its benefactors are parishioners.  Clergy also act as a referral source by identifying families in need. Dr. Trinh and her staff currently care for 268 patients. They hope to reach a panel of 500.  

Like other direct care doctors, Dr. Trinh provides exceptional care by ensuring that her patients also have a pathway to diagnostic and specialty care — some of the more difficult health services to reach for the most vulnerable. Her partnership with Project Access, a volunteer physician program that has been around for two decades, assists the clinic’s mission of providing holistic charitable care by donating extensive lab testing for low-income uninsured. In 2013 alone, Project Access doctors affiliated with Duke Raleigh, Rex Healthcare, and WakeMed donated $15 million worth of charity care to almost 4,000 patients in Wake County.

It doesn’t stop there. St. Joseph Primary Care also carries out its mission by participating in Day of Caring (DoC). On this day, the nonprofit collaborates with local physicians, dentists, church volunteers, and UNC students from the Catholic Medical Society to provide free heath screenings at a makeshift clinic in a local church. Services include but are not limited to flu shots; blood pressure, blood sugar (A1C), and cholesterol monitoring,; dental screening; and diabetes coaching.  They also work with REX Mobile Mammography so that uninsured patients can have access to free mammogram screenings through the UNC Rex Healthcare System.

A lot can be accomplished when communities are left alone to devise simple and effective ways to extend medical assistance and support services. St. Joseph Primary Care is just one representative case study within the entire DPC movement. It’s a contagious concept, and it’s all in good taste.

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Katherine Restrepo is the Director of Health Care Policy at the John Locke Foundation. Before joining the John Locke Foundation, she interned at the Cato Institute under the direction of Michael Cannon, Director of Health Policy Studies. Katherine’s… ...

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