This post is going to be relatively short, and may seem a bit frivolous, but I wanted to write it because it’s about a seemingly small thing that reveals a much deeper truth about DPC (Direct Primary Care) and how it differs from a traditional primary care setup.
Recently I purchased a Nespresso Vertuo machine for the office. I’m a bit of a coffee snob, and let me tell you – this thing makes amazingly delicious espressos.
What does this have to do with you?
In my former job, at a large corporate style practice, the business model was thus: see a patient, bill their insurance, repeat. Overhead was very high – because we had to employ an army of staff to take care of all the billing and paperwork created by the insurers. Margins were extremely low, because the reimbursement rates from the insurers were arbitrary, unpredictable, and frequently insultingly low. (I once saw a patient for four visits on four consecutive days for a bout of pneumonia. This kept him out of the hospital, which aside from being good for him, probably saved his insurer a cool five or ten thousand dollars in expenses. I was reimbursed a grand total of $15. No, I don’t mean $15 per visit. I mean $15 total for all four visits combined).
In this model, the only way to make a decent living was to see as many patients as possible and to cut all non-essential costs to the bone. Coffee was not offered to patients, and the coffee machine for use by the staff in our break room produced a disgustingly acrid black liquid that was good for inducing a caffeine jolt, but, if served to prisoners of war, would likely have violated the Geneva conventions.
In the world of DPC, everything is different. I work directly for my patients, and my highest imperative is to make sure they get great care and have a good experience interacting with my office. I’m also now a small business owner, and I am empowered to make any change to my work environment that I think will make my workday a happier and more productive one.
Ergo, the Nespresso machine. Evelyn and I have been enjoying wonderful coffee here at the office, and we always make sure to offer a cup to our patients when they come in the door.
It’s just a small touch that helps us make our patients feel more welcomed and cared for. But it is also a powerful symbol of how much different a doctor’s office can be once it is run like a small family business that exists to serve its customers, rather than a large corporation that exists to serve the needs of another large corporation.
