The point of contact for most medical concerns is a family or primary care doctor. Referrals to specialists
and other clinics for more advanced diagnosis and treatment are usually made by the the primary care physician (PCP), making
your primary doctor critical to your overall care. Your PCP can also be extremely useful in helping you find cash-friendly
Most family doctors will allow you to pay cash for your care, though a smaller number will be able to tell you what various services cost, especially
before any care has been given. Some physician practices operate under a model called direct primary care (DPC). In the past this was categorized
together with concierge care, though the two have some important differences. With DPC, a patient either pays a monthly membership fee which covers
most services (so that no additional payment is required), or the patient may pay for services a la carte, as needed. DPC practices typically
publish both membership fees and a la carte prices for all to see – many on their own web sites.
Traditional physicians often accept new patients, because they spend a very small amount of time with each one, and there is little predictability
as to when a patient may come in. DPC practices fill up more quickly. As of 2016, a majority of traditional physicians nationwide were no longer
accepting new Medicare patients, as government reimbursements to doctors continues to decrease, and regulatory requirements increase. Most DPC
practices are new enough that they still accept new patients, but that could quickly change.
Most DPC practices are small and independent, and so far there has been little data gathered on their relative effectiveness and quality.
Two of the most mature DPC associations, Access Health Care and Qliance, have seen reduced demand for specialty and emergency services
as patients have used comprehensive primary care.