How Many Direct Primary Care Practices in Michigan?

The number of Direct Primary Care doctors in Michigan is difficulty to quantify. A reasonable place to start is with a definition of what Direct Primary Care is and is not. Philip Eskew is both a lawyer and a DPC physician over at DPC Frontier, and he sets forth a good criteria: 

FOR THE PRACTICE TO QUALIFY AS A DIRECT PRIMARY CARE, IT MUST:

1) CHARGE A PERIODIC FEE 

2) NOT BILL ANY THIRD PARTIES ON A FEE-FOR-SERVICE BASIS, AND

3) ANY PER VISIT CHARGE MUST BE LESS THAN THE MONTHLY EQUIVALENT OF THE PERIODIC FEE

I wanted to apply this definition to the State of Michigan, my home state, to see how many "DPC" practices meet this criteria. As far as pure Direct Primary Care offerings open to the public, there are two: Chad Savage, MD with YourChoice in Brighton and Plum Health DPC in Detroit. 

There are other Hybrid DPC offerings within clinics that also bill third party insurance companies: Dr. Younes in Dearborn, Dr. Tindle in Grand Blanc, and Dr. Kevin Roy in Saginaw. I take issue with the Hybrid practices, because you lose the accessibility piece that makes DPC such a great delivery model - these doctors are still seeing a significant number of insurance-based patients and offering DPC to a subset of patients. So if a DPC patient needs to be seen, they "jump the line" and are seen ahead of the insurance-based patients. This is less than ideal.

Premier Private Physicians offers what I would define as Concierge Care or Concierge Medicine. The membership is $200/month or $2400 for the year and some labs and vaccines are billed to insurance companies. Visits are included, but they do not have contracts for at-cost meds, labs, or imaging because their patients are typically high income earners/wealthier people who are not as cost sensitive. 

The other category of "DPC" in the State is employer-based DPC. Some large employer groups like United Shore have contracted with a "DPC" provider like SALTA or ProactiveMD to have on-site doctors to care for their employees. These practices are not open to the public and people who are not employees at these companies cannot access these services.

Because the access to care is limited, this operates more like a third party structure as the large company finds that it saves money to pay a capitated rate for each employee to an on-site doctor, rather than the patient using their employer-provided insurance to seek out urgent care or emergency services. Unfortunately, employees may start to use the "DPC" doctor more for urgent care type visits and less for primary care, chronic care, or preventive services. 

If you wanted to include all of the above practices in the definition of DPC, there are roughly 8 "DPC" providers in the State of Michigan. My argument is that there are only 2 "pure" or authentic DPC practices in the State of Michigan. Sincerely, I would love to see more doctors taking the plunge into authentic DPC medicine, and am here to inspire, encourage, and consult other doctors to do just that. 

If you want to add to the conversation or debate, please send me a message or write a comment below!

Thanks for your time,

- Dr. Paul with Plum Health DPC