Ok raise your hand if you've ever been frustrated by ever rising health care premiums, higher and higher deductibles, long waits to see your doctor, and rushed short visits when you finally get it? I know my hand's up! As a patient myself, I hate the frustration of not knowing how much a procedure or visit will cost, and wondering if a medication is covered, or a specialist I want to see. On the flip side as a doctor in an insurance-based practice, insurance dictates how I can practice, rates given to patients, what I can prescribe, and when and how I treat my patients. Many people may not realize this, but insurance has a strong hold on the practice of medicine, all the while raising our costs and covering less and less. So who wins in this crazy, messed up healthcare space? It's certainly not the patients, nor the providers at the forefront of delivering care. If the healthcare insurance CEO salaries and bonuses are any indication, the only winners in this game are the for-profit insurance companies. Welcome to our 3rd party payer healthcare system in the U.S.! 

But what if I told you there's a movement to bring medicine back to the way it has been practiced for centuries? Removing the middle man (insurance) for routine, preventative care, and restoring the patient-physician relationship with transparency, affordability, and autonomy? Yes, please! Welcome to the world of direct pay medicine, specifically dermatology.

So, What Exactly is Direct Pay Dermatology?

Direct pay dermatology is just like it sounds. It's a way of practicing dermatology where patients pay for their visit with their doctor at the time the service is rendered, directly to their doctor. Groundbreaking right?! This re-aligns the patient-doctor relationship back to where it should be, and eliminates barriers imposed by insurance companies. Patients no longer have to deal with confusing copays, deductibles, and surprise bills. Instead, they can visit a dermatologist's website, where transparent pricing and appointment availability are clearly displayed. With direct pay dermatology, you pay directly for the care you receive, making healthcare more transparent and accessible than ever before. 

Now, let's clear up a common misconception: direct pay dermatology is not the same as concierge medicine. Concierge medicine is typically insurance-based, whereby people can pay an additional membership fee for more VIP service such as increased accessibility to their doctors and shorter wait times. On the other hand, direct pay dermatology operates independently from insurance. You pay upfront for each service without needing a membership fee, or insurance.

Dermatology is a perfect fit for direct pay models as many dermatological services aren't covered by insurance, despite being medical conditions. Take for instance acne: while most insurance plans will cover medication treatment of acne, they won't cover peels or laser therapy, or the treatment of acne sequelae like scarring. This leaves patients paying out of pocket for these treatments. Direct pay dermatology simplifies things by offering clear prices upfront, cutting out the confusion of insurance coverage, or lack thereof!

What are the Advantages of Direct Pay Dermatology?

1) Focus on Patients

Direct pay dermatology puts patients first. By ditching insurance hassles, dermatologists can concentrate on each patient's unique needs with lengthier appointments whenever patients need them.  No more waiting 1 year and 1 day for your next routine physical! Doctors can also focus more on preventative care with full autonomy to provide the best care for each patient without insurance dictating treatment algorithms. This approach reduces burnout for doctors as well and enables strong bonds between doctors and their patients.

2) Clear Prices, Lower Costs

Transparency is key in direct pay dermatology. This is the opposite with insurance payers! With upfront pricing and no surprise bills, patients can confidently budget for their skincare needs.  In addition, the overhead of running a direct pay practice is considerably lower as it doesn't require the manpower of multiple staff to run claims, and fight for reimbursement. This means more affordable care for patients without insurance inflation. 

3) Easy Access and Convenience

Direct pay dermatology is designed with the modern patient in mind, offering flexible scheduling options, extended hours, and even virtual visits for many. Say goodbye to long wait times and hello to same-day or next-day appointments! With direct pay dermatology, getting the care you need has never been easier or more convenient. And don't worry about rushed visits, those days are gone with direct care!

Finding a Direct Pay Dermatologist

While still not the norm of practicing, direct pay dermatology is becoming more popular, and you can find dermatologists who offer this service in a few ways. One way is to search online directories like the Direct Specialty Care Alliance (https://dscalliance.org/) or ask for recommendations from friends or family. As more people and doctors become increasingly frustrated with the current insurance model, direct pay medicine  is likely to become more and more popular for all. Ultimately, this gives patients more options and puts them back in charge of their health.

While direct pay dermatology offers many potential benefits, transitioning to direct pay dermatology comes with its own set of challenges and things to think about. Some patients might find it hard to switch from traditional insurance to direct pay, especially if they have a low deductible or premiums. Also, direct pay may not work well for all medical needs, especially emergencies or complex surgeries that usually need insurance coverage. Similar to car or home owners insurance, people likely will need to keep some form of health insurance in the future, while opting to self pay for more routine care.

If you're ready to learn more about the world of direct pay dermatology, be sure to tune in to this week's podcast episode with Dr. Stephen Lewellis, where we'll dive deeper into the world of direct pay dermatology. 

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https://lewellismd.com/

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