News & Updates

Why the Direct Pay Model would work well for the poor population.

One of the ideas which people perceive about Direct Primary Care is it’s only affordable for wealthier incomes. This article, which was well written by Marguerite Duane, MD, MHA, debunks the reasoning behind it. The link to the original article can be found at the bottom of the page.

So, if poor people have little to spend, why would the direct primary care model work for them? Simple; with direct pay models the actual health care costs can be kept much lower and therefore more affordable for these very patients. Plus, since direct pay models often have smaller patient panels, these patients may have more time with their physicians and staff to address the myriad of issues in their life that may be affecting their health.

Some direct pay models charge patients a monthly or yearly membership fee that covers all primary care office visits and even some basic or in-house labs. For example, at Qliance in Seattle, depending on the patients’ age, members pay a fee that ranges between $54 – $94 a month, which includes:

7 -day a week access to the Qliance health care team
Same or next-day appointments for urgent care
30-60 minute office visits
Phone appointments and e-visits
After hour phone access to a physician for urgent medical needs

Sure, direct primary care is great because it covers all primary care visits, but you may wonder how will poor patients pay for labs or specialty visits? It may surprise you to learn that the actual cost of most basic labs is actually very little. We negotiated with local labs to pay just above the actual cost of the tests and in exchange, we pay our lab bill in full monthly. Here is an example of how it would work for a patient with diabetes:

Labs Actual Cost Patient Paid at time of visit

HgAIC $8.72 $10
Lipid panel $3.47 $ 5
CMP $4.21 $ 5

What about the cost of specialty care, clearly this is much too expensive for poor people to afford, right? My response to that question is two-fold:

First, one of the main benefits of the direct primary care model is physicians have more time to spend with their patients to actually figure out what is wrong and treat problems appropriately; and therefore, they need to refer patients less often. As family physicians, I believe we are well trained to handle the myriad of problems that patients may present with, but we do not have enough time to adequately address them in a 10 minute office visit, so we often feel compelled to refer them to specialists. QIiance has demonstrated that when you have the time to spend with patient, specialist and ER visits, surgeries and hospitalizations are all significantly reduced

Second, even specialists are willing to reduce their fees when they are guaranteed payments in a more timely manner. Again, when we eliminate the insurance middleman, we significantly reduce the uncertainty and/or time it takes to pay for services. In reality, fees for sub-specialty visits, services, surgeries, etc. are set for insurance companies who routinely underpay by a significant amount, since they can negotiate much lower payments. Again, if we could eliminate the “insurance bureaucracy tax” by reducing administrative costs through the removal of the insurance middle man, specialists could charge patients much less for the actual services they provide.

The original article can be found here from The Direct Primary Care Journal

What We Strive For With DPC

One of the main reasons I decided to make this huge career change into a Direct Primary Care practice was to give patients what they deserve from their doctor….time. One of my patients that followed me from my old practice has allowed me to post this wonderful testimonial she wrote on Facebook on Friday. Many thanks to her for doing so. This is an example of what true patient and doctor satisfaction are about:

“Today I had my first official appointment with Dr. Jeffrey Gold at Gold Direct Care. It was a phenomenal experience. His new office space is beautifully decorated and comfortable. Dr. Gold spent quite awhile with me, answering numerous questions and making me feel, as he always does, at ease. Has anyone ever gone to their primary care doctor and been greeted with: “Would you like some coffee or tea?” My visit was an experience- not rushed, not pressured to hurry up. If you want a primary care doctor who sincerely cares about you and your family and is in the practice of medicine to do just that, then you have to meet with Dr. Gold and see what Direct Primary Care is all about.”

Open Enrollment: What To Do Next

For all of you who are in the enrollment period for employer-based insurance, including town employees, we can help answer your many questions. We offer free one hour consultations to help look over your insurance benefits. We also show you how Gold Direct Care can complement your insurance in a way which accomplishes two main goals:

1) Provide you with better access to primary care (AKA better quality care) with a doctor that is available to you when you need them. Appointments guaranteed within 24 hours and no insurance hassles.

2) Lower your cost. By combining our aged-based monthly fee with a lower premium/higher deductible plan we can get you to either break even for better value or, best case scenario, we can save you money all the while keeping you protected medically and financially.

We understand how complex insurance options can be. We are here to help you become a better consumer and navigate these complexities, so you and your family are protected; all the while getting the best value for their dollar. Please contact us for any inquires and to set up a time to talk at info@golddirectcare.com or 781-842-3961.

We also have knowledgeable insurance consultants as well whom we can direct you to if needed.

Here is an article with great examples if you would like to learn more: What Really Happens When You Cut The Red Tape

Tufts Family Medicine

So today I spent an hour speaking about Direct Primary Care to 1st and 2nd year medical students at Tufts University that are interested in Family Medicine or Primary Care in general. It was a great experience to see students engaged and interested in pursuing a field of medicine that desperately needs young, bright, and energetic minds. They asked intelligent questions and hopefully learned that there is hope on the horizon for primary care. There is a currently a shortage of good primary care physicians across the country, but especially here in Massachusetts. We need to fix this and the only way to do so is to make Family Medicine palatable, financially rewarding, and most importantly gratifying by focusing on patient care. Read this article from 2013 for more information: http://www.beckershospitalreview.com/hospital-physician-relationships/primary-care-shortage-dire-in-massachusetts.html

Direct Primary Care, in my opinion, is a way to build off the positives of our healthcare system and simultaneously remove the bureaucracy and red tape of insurance that does nothing to help patients or control costs. We have a solid foundation to work off of, but we have to modify it without scrapping the whole construct. DPC does this. It allows insurance to be used the way it was intended to be used- for catastrophic, high cost events or illnesses.

In my hour with them today, I hope I was able to show the students that if we keep fighting the good fight and do the right thing, maybe someday DPC will become the norm rather than the exception. I hope the more than 200 patients we have enrolled already can attest to the value and quality of this old, yet new, model of primary care.

As Albert Einstein once said the definition of insanity is doing the same thing over and over again and expecting a different result.

A Different Kind of Plan

Marblehead’s Gold boosts Direct Primary Care plan – Itemlive.com

55220adfd9333.image — A different Kind of Plan

MARBLEHEAD — Direct Primary Care is a concept based on the idea that physicians should be dedicated to their patients, and care for them based on their needs, not their insurance plan, says Dr. Jeffrey Gold.

The concept strives on building strong patient/physician relationships and eliminating third parties, such as insurance companies, for primary care.

Many believe it’s a solution to a lot of the problems we see in the primary health care system: waiting time, high costs, and not understanding treatments. Gold is one.

“Let’s get back to using health insurance for what insurance should be used for: the big things, the unexpected things, surgeries,” said Dr. Jeffrey Gold of Gold Direct Care in Marblehead, “not the day-to-day primary care which is expected and what people need.”

Instead, DPC offices charge a fixed monthly rate and provide patients with unlimited doctor visits and unlimited time during each visit. Doctors spend more time with patients and are able to provide a wider variety of care so that most procedures can be performed in the office, Gold says.

When a patient does need to be referred to a specialist, DPC doctors communicate extensively with the specialists in order to ensure the best care for the patient. “When I do refer out, I have a much better dialogue with the specialist,” said Gold.

“I have better referrals, because I’m not referring as many people out and I can communicate with the specialist because I have more time,” he said. “This results in better care for the patient, which is the ultimate goal and should be the ultimate goal.

“This is getting back to what medicine is supposed to be about, which is the patient and physician relationship,” said Gold. “The doctors in the program are trying to provide quality care but the current system doesn’t allow it.”

This method is an attempt to stray away from the traditional medical system, which Gold says has become more about “how many people you can see rather than the quality of the care.”

“Our goal is to help the patient,” he said. “It’s difficult when you’re in a room seeing 20 people a day. That’s not why I went to school for so long.”

Gold aims to have about 750 patients as opposed to the 2,500 he had when working in traditional medicine. The purpose, he said, is “for the patient to really have a lot of questions and be more engaged with their health. I have the opportunity to do that.

“It’s gratifying to spend time with people that you genuinely care about and make sure they are getting what that they need,” he said.

While DCP does not involve insurance directly, a membership does not take the place of insurance. It’s important to know that you still need insurance for emergency situations and surgeries.

“DCP is not insurance, it’s a service.” Gold said.

“All primary care services are included under that fee. I can still take care of someone who doesn’t have insurance but I would never encourage someone to not have insurance. We recommend a high deductible plan so that you’re covered in all aspects of your care.

“We’re trying to work with insurance companies to get the right plan for people. Get them higher quality care,” he said.

While eliminating insurance all together is not recommended, the idea behind DCP is to remove it at the primary care level.

“I work like a gym membership; people can use it or not use it but they’ve paid for the service,” he said.

“Patients pay “a monthly age-based fee that pretty much encompasses 99 percent of what I do in the office,” he said. Falling under the remaining one percent are things like blood work, routine women’s health screenings and even house calls, which Gold says range between $3-$30.

According to Gold, there are many added benefits of being a patient of a DPC office. Doctors have 24/7 availability. They give patients their cell phone number, giving them the option to call, text, email, FaceTime and skype.

“I can talk to a patient on the phone from the comfort of their own bed,” said Gold.

For Gold, it’s about changing the experience patients have with health care.

“Nobody wants to go to the doctor and we’re trying to change that,” he said “It’s up to us to try to fix this and make it better and the only way to do that is to think outside the box and make things simpler.

“It allows for people to have a say in what they’re getting and how they’re getting it,” he said “I hope we get to the place where people demand better and get better.”

Letter of appreciation from a patient

We received this thoughtful note from a patient today. It is truly rewarding to continue relationships with patients year after year, especially in the new form of direct care.

Dear Dr. Gold:

Congratulations on your new venture. I truly like the concept of your practice but most importantly, I am glad that I have the opportunity to continue to be a patient of yours. After being part of your practice since the beginning my decision to stay was an easy one. You have always provided the utmost professional and personal care and I look forward to this continued relationship.

Good Luck Dr. Gold and Meghann, I can’t think of a better team to be affiliated with. I look forward to the great care and personal touch that I have always received with you.

Open House and Information Sessions in February

We’ll be hosting a number of sessions in the coming weeks to give you a chance to visit the new office of Gold Direct Care in downtown Marblehead. Please stop in to see the office and meet our team.

Dr Gold and Meghann Dunn

There are two types of events planned:

OPEN HOUSE – All are welcome. Open to the public, no RSVP needed.
Come see the new office, meet Dr. Gold, and learn more about Gold Direct Care. Snacks and refreshments will be served.

Three open houses:
– Monday, Feb 23rd, 4-6pm
– Wednesday, Feb 25th, 4-6pm
– Friday, Feb 27th, 4-6pm

INFORMATION SESSIONS – Space is limited. Please RSVP for a specific session via email or call 1-800-939-1850, Ext 1.
Dr. Gold will give a detailed presentation on Gold Direct Care, including Q&A for patients, employers and local businesses.

Four session times:
– Tuesday, Feb 24th, 12-1pm and 4-6pm
– Thursday, Feb 26th, 12-1pm and 4-6pm

All events will take place at the new office of Gold Direct Care at 123 Pleasant St, Suite 105, Marblehead, MA. Our office is the front-right corner of the new building that houses the Warwick Theater and Palmer’s Restaurant. There is ample parking behind the building, and you can enter directly from the door adjacent to the parking lot.

Meet Meghann Dunn

Meghann is the nurse and office coordinator at Gold Direct Care.

meghann at desk “Hi, I’m Meghann Dunn. I was born and raised in Florida and moved up to Massachusetts about six years ago. I have always wanted to help people throughout my life, and have been volunteering at food banks and homeless shelters since I was young. When I moved to Massachusetts, I found my passion for helping others could be realized through becoming a nurse.

My hobbies include playing and coaching soccer, hiking, kayaking, and reading the occasional horror novel.

I am excited for the opportunity to work with Jeffrey Gold because I truly believe in his vision. I fully support anyone who feels everybody deserves access to quality healthcare. Being able to be a part of a family care setting, where there is more of a direct relationship between patient and healthcare providers, will give me the opportunity to understand my patient’s individual needs.

I am proud to join Gold Direct Care and I look forward to working with you and yours.”

Gold Direct Care Office Opens in Downtown Marblehead

We’re thrilled to announce the opening of our new office!

Construction wrapped up last week, and we’re still working on stocking the supply cabinets, but the office is open and we’re seeing patients.

Update: Open houses scheduled for February.

When you first visit Gold Direct Care, you’ll immediately notice that we’re different from the typical doctor’s office. Read more about what makes a Direct Primary Care Office special.

What Makes a DPC Office Special?

One of the key differences between a conventional insurance-based primary care practice and a Direct Primary Care practice is the overall structure of the office space. (see the latest update on new location)

When you first walk in, you’ll immediately notice a difference:

Instead of a large waiting area, we will have a cozy “lounge” area. I do not call it a waiting room because patients will not actually WAIT to see me or my nurse Meghann.
There will not be a crowded waiting room with contagious patients. There will be no front desk staff of 5-10 employees. Instead, patients who enter the door will be greeted by Meghann at the reception desk, checked in without the need to verify “insurance”, and brought back into an exam room.

The exam rooms are different, too:

The exam room as well as the rest of the space will be a warm, homey environ with lots of soft colors and natural light so patients feel relaxed.
The space will be sterile and immaculate without feeling like a a cold and impersonal conventional office.

Your visit with me will be thorough and personalized:

Instead of visits that last 15 minute or less, patients will be in the exam room or my office for no less than 30 minutes (or even more if needed).
There are no rushed visits with patients being filed in and out of exam rooms.
There will be no computers or kiosks in the exam room. Attention will be given to the conversation being had with the patient. Laptops may be brought in on occasion to demonstrate medical education or show anatomical pictures, but never at the expense of patient-physician interaction.

The whole focus of a DPC office is to make our patients feel relaxed and comfortable, whether they are there for a routine checkup or a sick visit.

We want our office to feel like our patients’ true medical home!