This also grants physicians more time with their patients to thoroughly address each concern. The lower patient load (500 patients vs ~2,000 patients) in the DPC model, doctors can get to know their patients’ stories, health care goals, and priorities. In many ways, the DPC model is a win-win for both patients and primary care physicians. The doctors of Plum Health feel fulfilled in their calling to medicine through their collaborative doctor-patient relationships and steady compensation thanks to the flexibility and autonomy built into the DPC model. They shifted to more curbside testing and virtual care for concerns surrounding COVID-19 to ensure the safety of patients who continue to be seen in clinic for typical health care concerns. Some physicians in direct primary care (DPC) practices have especially appreciated the autonomy and flexibility of DPC during a pandemic.ĭPC practices typically offer patients direct, unlimited access to their services, including longer appointment times, for a flat monthly fee, and they don’t bill insurance.Īt Plum Health DPC in Detroit, clinic founder Paul Thomas, MD, and his colleagues Raquel Orlich, DO, and Leslie Rabaut, DO, became more flexible in their health care delivery during the height of the pandemic. Policymakers should also set health equity standards and provide effective economic support to help healthcare organizations achieve this work.The COVID-19 pandemic exaggerated the frustration and exhaustion of physicians within standard health care systems. "Quality improvement efforts should be explicitly designed to improve health equity," they wrote. "Quality improvement efforts without a focus on disparity reduction may have limited effects on health disparities and in fact unintentionally worsen them."Īddressing the "fifth aim" requires healthcare leaders to identify health disparities, implement evidence-based interventions to address them, measure progress and incentivize achievement of equity. "The reasoning for adding equity as a fifth aim is similar: Quality improvement without equity is a hollow victory," they wrote. The op-ed's authors said the triple aim was expanded after experts realized that quality improvement work would be unsustainable if healthcare facilities did not address burnout. This term evolved into the "quadruple aim" in 2014 to include a focus on addressing worker burnout. Quality and safety experts at the Institute for Healthcare Improvement first penned the term "triple aim," in 2006 to address a joint focus on improving population health, enhancing patient experience and lowering costs.
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