Ramstad: The Minnesota doctor’s offices where you don’t need insurance

With a client base of 500 to 600, a fraction of the 2,000 to 3,000 they might see in a major health system, a DPC doctor charging an average monthly per person fee of $80 would generate around $500,000 in annual revenue. That would well cover the average salary for a family doctor, which is about $225,000 nationwide, and leave room to pay for other expenses, perhaps an office administrator and part-time nurse.

For patients, the calculation can be more complex. Slings and Vang told me most of their patients maintain insurance to cover emergencies or the prospect of hospitalization. Some turn to health shares, many of which are organized by faith organizations and serve as pools of funds designed to cover catastrophic care for their members.

If the deductible on your medical coverage is high, like mine, then taking on the additional fees of going to a DPC doctor represents a gamble.

It will pay off if you wind up visiting the doctor two or three times in a year on top of a physical. That’s because for most single adults with a high deductible policy, a physical is usually covered but each additional visit can be several hundred dollars, costs paid out of pocket until reaching the deductible of $2,000 or $3,000 or more. Cumulatively, those out of pocket costs could exceed the annual cost of a DPC doctor.

For a couple or family, it seems to me there’s a greater likelihood of needing a doctor multiple times before reaching the deductible, even if that threshold is higher than for a single person.

Of course, even if it costs extra, some people may feel it’s worthwhile to have more time and quicker access with a doctor. If direct primary care proliferates, new types of insurance may form around it.