New Models of Patient Care

By Dr. Ingrid Liu, D.O.

• “United Healthcare to exit most state insurance exchanges” – Chicago Tribune, April 19, 2016
• “Big news for Chicago-area Obamacare insurance exchange: Cigna seeks to join”  – Chicago Tribune, July 26, 2016
• “Aetna pulls out of collapsing Obamacare” – Daily Wire, August 16, 2016 “
• “Blue Cross & Blue Shield of Illinois, which dominates the market, is raising premiums substantially and possibly re configuring product lines and networks after losing $488 million on the individual market (including both Obamacare lines and commercial policies) in 2015 and $290 million in 2014.” – Crain’s Chicago Business, August 27, 2016

Who can keep track of all this? How are the independently insured going to get medical care?

Doctors are not happy and neither are patients. I have colleagues that have decided to stop patient care completely, changing to new careers in consulting, research, entering early retirement (if that’s an option), or any number of non medical options.

Unfortunately there are only so many hours in a day and insurance plans only pay so much for each office visit (no matter how much premiums cost or how much doctors beg and plead). A physician has to see on average 30 patients/day in order to succeed. This therefore translates to 10-15 minutes per patient in a 8 hour day. This, as we know, is not good for either the physician or the patient.

When physicians spend more time with each patient, we get to know them each individually and thoroughly, allowing for better decisions and treatment plans as well as guidance on preventive measures.

Primary care physicians are changing their practices to offer patients options.  I am a family medicine physician and I switched my practice to a membership model 2 years ago. This has been called concierge medicine but I prefer to call it old fashioned medical care in today’s healthcare system. By limiting the number of patients under my care, I am not only able to address more questions from the patients, but my office staff also assists with coordinating care from specialists. We also assist in navigating this complicated insurance maze.

Because the health insurance policies are so complicated, another model that now exists is called Direct Primary Care, or DPC. This type of practice charges a small membership fee and does not accept any health insurance contracts, charging patients a set fee for services, similar to a menu at a restaurant or items at the auto repair shop. There are only a few of these practices nationwide but are growing in numbers.

Especially in this election year, health care reform continues to be a hot topic and I’m not writing to express my point of view other than that change needs to happen and is happening. There is growing concern over a shortage of primary care physicians. Please ask your family physician or pediatrician how he/she is doing. You may be surprised to hear the answer. I know the question would be welcomed and appreciated (as long as there’s time during the appointment to ask it)!

Editor’s Note:
Dr. Liu has provided family medical care for thousands of patients of all ages over two decades. She is board-certified in family practice and licensed without restrictions. She currently serves on the board of Easter Seals DuPage & Fox Valley and is also a member of the Illinois Academy of Family Practice Committee on Mental Health. Dr. Liu is proficient in all aspects of primary care, but holds special interests in women’s health and travel medicine. http://www.wellcomemd.com/. Learn more about her practice in the video below.