My DPC Journey - Part 1
To those of you who know me, some of what follows might bore you, but for anyone just discovering Momentum DPC, please allow me to introduce myself.
I’m Lucas Beeley, Doctor of Osteopathy, Board Certified Family Practice physician. I was born and raised in this great State of Ohio. I studied medicine at Lake Erie College of Osteopathic Medicine in Erie, PA. I completed my FP residency at (formerly) Cuyahoga Falls General Hospital in 2009, and have been practicing in the Columbus area ever since. Most of my patients know me from the 12+ years I spent practicing in Dublin as a member of a large hospital group.
In December of 2023, in a move upsetting to some, (and perhaps to the delight of others) I stepped away from my previous role to devote the necessary time to starting up my new DPC clinic. I hope everyone knows that this was a very difficult decision for me, and I truly appreciate the experiences I shared with so many patients and co-workers for well over a decade.
So why the sudden change?
Like many family practitioners across the US, I have grown to understand that the world of corporate medicine, and, in particular, its heavily administrative, overly bureaucratic fee-for-service (FFS) model, is simply not conducive to the quality of care that I set out to provide. Not only do we necessarily spend far too much time doing paperwork, (both virtual and physical) the model depends upon a very high ratio of patients to providers. Doctors in the standard FFS model are paid based on productivity, so the more patients you see, and the greater the documented “work” (meant to reflect the level of complexity) dictates the relative value earned in each encounter and are paid accordingly. You are incentivized to see as many patients as possible, but with this incentive comes several costs. Far shorter visit times. Longer scheduling wait times. Increased demand by third-party payers (in the form of documenting and coding) to prove that the dollars they’re being asked to send to your company accurately match the fees being billed for each encounter. These negatives really compound when you factor in all the other duties associate with patient care. Answering questions and responding to messages, reviewing and discussing test results, refilling prescriptions, completing paperwork for disability, FMLA, prior authorization for denied services, (in the form of prescription medications, referrals, tests and imaging) etc. Tack on to that all the meetings, emails, compliance with various and ever-changing rules and mandates, new care initiatives and service goals, metrics, scorecards, and pressures from above, and it becomes easier to see how a once-beautiful profession could for many doctors become almost soul crushing.
While I do not pretend to speak for all primary care doctors, I will admit that for me personally, my level of career satisfaction has been falling precipitously for years. But what could be done? The prospect of leaving a large, established group and going solo is not only daunting on its face, but within the FFS model the only thing one ends up gaining is a little more office autonomy. Instead of a massive organization sharing the overhead and employing compliance experts, billing and coding specialists, IT, office support, medical assistants, supplies, etc, the solo practitioner must undertake all of that him or herself. The headaches associated with all of the FFS requirements make it nearly impossible to survive in the private practice setting. They are why so many longstanding private practices (what few still remain) have been increasingly selling their clinics to the larger corporate systems. I felt stuck.
Then I heard about the direct primary care model and I became convinced that it would be the best model for me. I love its simplicity and transparency. I love that it can afford me and my member patients more time to provide a greater depth and quality of care. I love that I can practice the kind of medicine that my patients and I decide to, with no one from an insurance company or the government telling us “no” simply because it isn’t on some predetermined formulary bingo card. I love the idea that it represents not only an alternative to the broken US healthcare system, but that it can serve as a tangible, functioning example of medical freedom and creativity standing in contrast to the status quo.
Consider joining the movement at Momentum DPC. Pre-enrollment is starting now.
