Reflections on My First Month as a Direct Primary Care Doctor

I feel I should pinch myself as I’m driving to my next housecall.  Who would have thought that I would be practicing Family Medicine the way I envisioned when applying to medical school, before my naivete faced the reality of the current healthcare system?

CovenantMD has leapt out of the gate!  From my many conversations with Direct Primary Care doctors around the country over the last several months, I formed expectations as to where CovenantMD would start, and how fast it would grow.  I’m happy to say that we’re busting these expectations.  It seems our local health care market is ripe for Direct Primary Care!

But as I reflect on my first month as a DPC doctor, I think less of the numbers and more about the quality of the product we’re delivering.  CovenantMD exists to re-establish the doctor-patient relationship.  And how are we doing?  Here is some of what I’ve seen during our first month:

People in dire straits are thriving again.  Many reach out to me because DPC is cool.  They see that it pairs well with a high-deductible insurance plan or sharing plan.  Many love the convenience of easy access to their doctor, or discounts on prescription medicines.  But there have been some that have reached out in desperation.  The system, in one way or another, is failing them — a long wait for an appointment, inconvenient appointment times, or the prospect of telling their story again to yet another provider in a multi-provider practice.  And what if that story is one of postpartum depression, or what if they're medical history is complicated?  With CovenantMD, the doctor is easily accessible and available the same day, he gives them the time they need, and he offers discounts on medication that can be delivered to their door.  Some problems don’t typically turn around in four short weeks, but I’ve seen amazing things so far.  Patients respond well when the healthcare system stretches just a little farther to meet them where they are.

Patients are enjoying easy access to their doctor.  Just yesterday a father texted me a picture of his four-year-old son’s rash.  While some rashes are certainly diagnosable by pictures, I still felt I needed to see this for myself.  So I buzzed over to their house, took a look, made a diagnosis, and prescribed medicine.  Then I shared a wonderful time with the parents in their kitchen laughing about the situation.  Why laugh about a rash?  Well, you had to be there.  Sorry.

Patients are getting the time they need with their doctor.  The other day I spent 90 minutes with a patient in his kitchen.  His medical story had many twists and turns, and we needed that time to formulate a picture of where he’s been, where he is now, and where he would like to go with regard to his health.  The current healthcare system is set up for primary care doctors to practice cookbook medicine — get barebones data, order the usual health-screening tests, prescribe the requisite medication (without regard to, or knowledge of, the cost) or make the knee-jerk specialist referral, and…NEXT!  But for me, much of the joy of Family Medicine comes from hearing my patients’ stories.  The name of an illness might be the same between two patients, but how they experience that illness, and their priorities for treating it, might be quite different.

Families are enjoying the chance to interview their prospective doctor.  Service companies give estimates.  Many of them have showrooms.  Why shouldn’t your family doctor vie for your service in similar ways?  Every week brings another handful of meetings in patients homes, or Starbucks.  Not only do I get good coffee, but when families do finally sign up for CovenantMD, they do so because they’ve met the doctor and they’re excited about what the practice can do for them.

If I could do this again, I’d rent my office space three months earlier.  Renovating my office space has been a frustrating game of deadlines moving back and back and back.  But as they say, good things are worth waiting for, and I’m proud of how the office will look when completed (in seven days!…but don’t quote me on that).  Stay tuned for news of our ribbon-cutting and open house!

Patrick Rohal, M.D. is a board-certified family doctor and the founder of CovenantMD.  He lives in Landisville, PA with this wife and three kids.  He thinks its definitely time to buy a snowblower.