Health Affairs

Concierge Care for the Masses

Direct primary care represents a new model for providers eager to spend more time with fewer patients and bypass insurance headaches. (2015)

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By Charlotte Huff

Steven Manning had been working at a hospital-owned practice for about two years and had been growing increasingly disenchanted with the level of care he could provide to 25–30 patients a day, many with multiple medical problems. “On those days I would walk out and sort of have this gut feeling that I’d missed something,” says Manning, a family physician in rural eastern North Carolina. “I often couldn’t pinpoint what that was. And I didn’t like that.”

Working on medical charts in his Williamston, North Carolina, office late one night in 2013, Manning suddenly recalled a presentation that another family physician had made to his residency program a few years earlier about a new style of practice called direct primary care. Within a year, Manning had opened the doors of his own direct primary care clinic, AccessMedicine.

Sometimes dubbed “concierge care for the masses” by proponents, direct primary care refers to an emerging style of physician practice that’s driven in part by the frustration of patients and doctors alike about treatment time constraints. But the approach has met with skepticism in some quarters, with concerns that it could aggravate the shortage of primary care doctors and lead to a two-tier health system.

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