Total Access Medical - Direct Primary Care Blog

Clear Benefits of Concierge  Primary  Physician Care Practices

Oct 05, 2017 by Cynthia Kuper, Ph.D.

Stephen C. Schimpff, M.D. Shares with us, in his blog last month in Medical Economics, the importance of the amount of time your primary care physician (PCP) spends with you, the reasons why they spend too little time and the serious consequences of that situation.  At Total Access Medical we share Dr. Schimpff's views and utilize this call to action by giving our patients the time and attention necessary to achieve the best outcomes of their over all health.

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The Consequences of Emergency Department Overuse

Jan 02, 2017 by William Kirkpatrick

Hospital emergency departments are a critical and indispensable component of the U.S. health care system which is why overuse has become a national concern and worry amongst hospitals, policy makers and healthcare providers. While their traditional mission is to provide trauma and emergency services for people in imminent danger of losing their life or suffering permanent damage to their health, the role of emergency departments has evolved over the past several decades. An increasing number of people are using hospital emergency departments for non-urgent care and for conditions that could have been treated in a primary care setting.

Why do patients seek care in the emergency department as compared to other care settings? Here are five causes of emergency department overuse:

  •   Patients have limited access to timely primary care services.

  •   The emergency department provides convenient after-hours and weekend care.

  •   The emergency department offers patients immediate reassurance about their medical conditions.

  •   Primary care providers refer patients to the emergency department.

  •  Hospitals have financial and legal obligations to treat emergency department patients.

The first four causes all relate to shortcomings in the primary care system. The rise in patient demand, fueled by an aging population and the growing burden of chronic disease, is outpacing the supply of primary care providers, which is compromising the system’s ability to deliver quality primary care services to all patients. Thus, the emergency department has increasingly filled that gap.


Related article: The Aging Effect on Primary Care

Related article: Why The Demand For Primary Care Physicians Outpaces Supply


For example, the inability of primary care practices to provide patients with timely appointments and after-hours and weekend care has driven patients to the emergency department for conditions that arise or worsen during those hours. Likewise, when patients in need of reassurance are unable to make an appointment or even speak with their primary care provider, they seek care at the emergency department.

Finally, patients also seek care in the emergency department at the explicit instruction of their primary care provider, their staff or answering service. Providers are increasingly overextended and are often unable to provide patients with same-day or even same-month appointments.

Consequences of Emergency Department Overuse

Inappropriate emergency room use creates major inefficiencies in both care and cost.

1. Crowding, long waits, and added stress on hospital resources, thereby lowering the quality of care for those with true medical emergencies.

2. Excess Costs

Emergency room use costs vastly more than its alternative. Experts estimate that the cost of an emergency department visit for a non-urgent condition is two to five times greater than the cost of receiving care in a primary care setting for the same condition.

Given cost differences and the high number of avoidable visits, it is estimated that emergency department overuse costs approximately $38 billion annually. 

Average cost of emergency department visit: $767
Average cost of office-based visit: $187
Cost difference:  $580

Cost Difference X (Total # of Emergency Department Visits X Percentage of Avoidable Emergency Department Visits) = National Emergency Department Overuse Costs.

$580 X (116.8 million visits X 56% avoidable Emergency Department Visits) = $38 billion

Nationally, 56%, or roughly 67 million visits, are potentially avoidable. Reducing this trend represents a signicant opportunity to improve quality and lower costs in health care. Reducing the overuse of emergency rooms will improve the care received by both urgent and non-urgent patients while cutting overall healthcare costs by billions of dollars each year.

3. Fragmented Care

A recent study found that most patients do not fully understand their emergency department care or their discharge instructions. Likewise, the health care system is poorly equipped to share patient visit information efficiently or quickly across care settings. Thus, care in the emergency department is rarely coordinated with care that occurs elsewhere in the system, including in the primary care provider’s office.

4. Overloading Hospitals’ Resources

An overload of hospitals’ resources make it harder for those with urgent conditions to receive the care they require.

5. Emergency Department Diversion

Nearly one-third of all hospitals have experienced periods of “Emergency Department Diversion,” having to divert some or all ambulances to other hospitals. In 2003, emergency room overcrowding forced half a million ambulances to be diverted; averaging one ambulance rerouted every minute.

The Solution 

Increasing access to primary care services can reduce emergency department overuse by up to 56%. A number of tested measures already exist, including offering alternative approaches to primary care, specialized services for vulnerable populations, and effective chronic disease management.


Related article: Direct Primary Care Saves Patients Money

Related article: Top Reasons Why Patients Love Direct Primary Care


But one solution stands out amongst the rest and is growing in popularity. The solution is called Direct Primary Care. Direct primary care is a newer form of concierge medicine in which patients pay a modest monthly membership fee in exchange for unlimited primary care services such as all-day access to a physician and unlimited appointment scheduling.

Are you interested in enrolling with a direct primary care practice? You're in luck. Total Access Medical is offering you the opportinity to meet for free with a physician today. 

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Top Reasons Why Patients Love Direct Primary Care

Nov 11, 2016 by William Kirkpatrick

It has been studied that patients enrolled in direct primary care experience a 50% reduction in emergency department visits, specialist visits, advance radiologic testing, and surgical procedures compared to patients enrolled in traditional primary care. The only number that increased is the number office visits, which more than doubled from an average of 2 visits to an average of 4 visits per year. Moreover, patients enjoy an improvement in health outcomes while saving on overall health expenditures when compared to those navigating the traditional health insurance system.

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Primary Care: Rushed Doctors & Dissatisfied Patients

Oct 24, 2016 by William Kirkpatrick

Doctors practice in an environment where treating patients with insensitivity and impatience has become the norm, and they are forced to spend an hour per day on insurance paperwork. According to the Wall Street Journal article titled, "Why Doctors Are Sick of Their Profession," there is a growing discontent among physicians due to insurance and administrative overhead causing rushed visits and ultimately, a growing number of dissatisfied patients. As doctor and patient dissatisfaction escalates, satisfaction within American health care system slowly deteriorates. 

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Why Can't I Spend More Time With My Doctor?

Oct 12, 2016 by William Kirkpatrick

You call your doctor's office for an appointment and are told it'll be about 3 weeks. You arrive on time only to sit in the waiting room for 30 minutes. Finally you get to see your primary care doctor and you begin to explain why you came in. The doctor asks a few questions, does a brief exam, gives you a prescription, suggests you see the specialist and within 10 minutes, you're out the door. No time for delving deeply into your issues. No time to build trust. No time for compassion. No time for actual healing.

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A Checklist For Your Next Doctor's Appointment

Sep 09, 2016 by William Kirkpatrick

A common issue regarding healthcare today is that people feel that their doctor’s appointments are rushed. Many people say that they don’t get enough time to ask questions and, consequently, do not fully understand the instructions their doctor gave them. Everyone gets about 15 minutes of face time with their doctor (unless you're a member of a direct primary care practice), so it’s often difficult to remember everything you wanted to bring up or that was discussed. Being prepared beforehand with a list of questions for your next doctor’s appointment will help ensure a more productive visit and increase the potential for a more effective outcome. Use these tips to prepare yourself for your next office visit:

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