More Madison doctors have switched to direct primary care as an alternative to the clinic system, citing the benefits of allowing closer patient-doctor relationships and more thorough care options.

Direct primary care is a system in which patients pay a monthly membership fee for a doctor’s office and are able to schedule appointments with that doctor as they need them.

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A direct primary care facility is a private practice run by one or several doctors. Under the increasingly popular model, doctors claim they can form better relationships with their patients and more directly personalize their care, according to the Direct Primary Care Coalition.

A growing number of doctors in the Dane County area are leaving the clinic system where they are given appointments by a supervisor. The clinic system can result in more patients and less time with each patient.

When doctors have a certain amount of patients they have to see every day, it can cause some doctors to feel burnt out — especially because the clinic system involves insurance paperwork, according to the Wisconsin State Journal.

With more doctors avoiding hospital care and opening their own primary care facilities, the future of direct primary care seems to be a bright one, said Dr. Wendy Molaska, president-elect of the Wisconsin Medical Society and owner of Dedicate Family Care in Fitchburg.

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Molaska said she was tired of how the hospital system assigned her about 2,500 total patients, whom she could only spend 15 minutes with per appointment.

“I burned out in the system,” Molaska said. “I was spending more and more time on paperwork that didn’t benefit my patients. It only benefited the insurance companies.”

Some doctors like Molaska feel as though the clinic system does not allow them enough time with their patients, obstructing their ability to help and to get to know the patient. By opening a private practice, doctors can schedule their own appointments, allowing for closer relationships with patients and more thorough medical care, according to the Direct Primary Care Coalition.

In this system, though patients have to pay about $100 a month, there are limited extra charges, such as for when extra operations may be needed. Patients also have more time with their doctors and some say they even have fewer problems scheduling appointments, according to the Wisconsin State Journal.

The model reduces emergency room hospital visits for patients using direct primary care, as well as reduced costs when patients do go to the ER. This is due to how often patients can visit their direct primary care provider, allowing for better, long-term health outcomes as smaller health issues are dealt with, according to a study from Milliman.

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Patients may feel as though hospitals are too expensive and go there only in an emergency. While direct primary care does require a monthly membership fee, for some it is still significantly cheaper than hospitals. Some direct primary care doctors even claim the extra operations patients have to pay for are cheaper than at hospitals, according to the Wisconsin State Journal.

Direct primary care practices work as a subscription service. Even though patients may use the practice more one month than another, they still benefit from reduced rates for radiology, labs and more, Molaska said.

For example, Molaska said in the hospital system one of her patients spent $135 for lab work that cost $3.50 at her office.

“While health insurance through bigger systems is more expensive for less care over time, patients in bigger hospital systems face two main issues — accessibility and affordability,” Molaska said. “In a hospital system, patients are stuck with whatever doctor is available. In direct primary care systems, doctors can build better relationships with their patients and advocate for them better.”

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Molaska said most people support independent doctors running direct primary care practices but also support doctors in larger hospital systems. She said she thinks the public will continue to support independent doctors as the direct primary care movement gains more traction.

In 2019, the Wisconsin Senate Republicans passed a bill that would lay the foundation for a direct primary care system. But Governor Evers vetoed this bill and said in the veto message it did not have adequate discrimination protection for patients.

“I object to allowing a health care provider to choose not to enter into a direct primary care agreement with a patient based on the patient’s genetics, national origin, gender identity, citizenship status, or whether the patient is LGBTQ,” Governor Evers’ veto message said. “I believe that all individuals should be treated equally.”

Evers said the Senate removed protections in the bill which would prevent doctors from choosing not to treat a patient based on their identity. There were still protections against discrimination based on race, age and class but issues such as sexual identity were no longer protected in the bill.

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Evers said in his veto he wished to ensure any patient who needs care and can pay for it will receive it and will not be refused care because of personal beliefs. No further action has been taken on the bill, according to the Wisconsin State Journal.

Even though this bill did not pass, some doctors in Wisconsin and across the country are continuing to make the transition to direct primary care practices, with several already recognized by the Direct Primary Care Coalition, according to their website.