Primary care physicians transform their practice models amidst the pandemic


We're living through the worst health crisis in a century. Yet, doctors' offices are largely empty. At the end of August, almost half of primary care providers said in-person visits were 30 to 50 percent below pre-pandemic levels.

Safety protocols have medical practices reducing the number of patients coming into their office, moving some to telehealth. But many Americans are also putting off visits to their primary care physician (PCP) due to fear of catching COVID-19. Nearly one in two adults have canceled or postponed an in-person doctor's visit since March, according to a recent MDVIP/Ipsos survey.

As a result, many independent practices are struggling to stay afloat. In another recent survey of primary care practices, 10 percent said they are uncertain about their solvency over the next month, and 20 percent of providers are now considering leaving primary care all together. And with no end to the pandemic in sight, more challenges surely lie ahead for our nation's PCPs.

These clinicians realize more than ever how endangered their practices are in a system that was already overstressed. Yet many are finding ways to maintain the health of their practices in a COVID world. By reimagining their business models, doctors can navigate today's turbulent environment -- while providing a better healthcare experience to patients in their communities.

Even before the COVID-19 outbreak, the rigors of running a traditional fee-for-service practice were driving many primary care physicians to the brink, with a staggering 79 percent of PCPs reporting symptoms of burnout. Having to see dozens of patients a day, and just a few minutes to spend with each, isn't healthy or sustainable. And it's a model that is uniquely vulnerable to a pandemic-induced drop in office visits. Fewer patients coming in the door means lost income.

That's why membership-based healthcare models are attractive -- and growing. At MDVIP, our affiliated physicians collect an annual fee from patients in exchange for preventive health services that are not covered by commercial insurance or Medicare. The annual membership fees, in turn, provide physicians with a more predictable and stable revenue stream.

The model also allows physicians to retain their autonomy and practice medicine the way they were trained. They can provide proactive, individualized care that is grounded in trust and a close doctor-patient relationship. According to the MDVIP/Ipsos survey, half of Americans believe that, in light of the pandemic, it's more important than ever to have a PCP who really knows them and their medical history. Another 42 percent believe it's more important that their doctors are readily available whenever they need them.

While physicians' offices across the country were forced to scale back in-person visits or even temporarily shut down during the pandemic, we saw many of our practices grow. MDVIP affiliates quickly implemented telehealth services and other measures, such as setting up drive-thru blood draws in parking lots, to ensure patients continued receiving the care they needed.

As we've also seen in our network, doctors are helping lift their patients' spirits during these difficult times. When states first issued shelter-at-home mandates, MDVIP affiliates continued to deliver care, comfort and communications in impactful ways. They made countless house calls and personal phone calls, oftentimes just to lend an ear to those who needed support during isolation. They hosted virtual town halls to educate patients and virtual cooking classes to keep them engaged. The resulting response from patients has been both overwhelming and moving.

Previously published research has shown that the model tangibly improves health outcomes. Patients who were treated by MDVIP-affiliated doctors were hospitalized up to 79 percent less than those in a traditional practice, according to a study published in the American Journal of Managed Care. In another study published in Future Cardiology, MDVIP physicians identified 40 percent more patients at risk for cardiovascular disease using advanced testing versus standard lipid panels.

The pandemic prompted physicians nationwide to start offering telemedicine services, which has proven to be an essential tool, even with its limitations. But telehealth won't be the only change coming out of this public health crisis.

Physicians are fundamentally rethinking how they practice medicine, and many are shifting to a membership model -- not just because it's good for sustaining their business. It's a better way to deliver patient care.

Bret Jorgensen is the Chairman and CEO of MDVIP.