Every fall, we are asked to make a surprising number of decisions about our healthcare. Which insurance plan should I choose? Should I pick the higher deductible or the higher premium? Do I need an HSA? Are my medications covered? Are my doctors still in network?
But there is another question I think we should be asking during Open Enrollment: Do I actually like the way I receive healthcare?
Not just your insurance. Your care. Because those are not the same thing.
We have gotten very used to thinking that our insurance company determines where we receive healthcare. You pick an insurance plan, look at the list of doctors who accept it, and somewhere on that list, you choose a primary care doctor. But health insurance is a financial product designed to protect you from the cost of healthcare. Your primary care doctor is the person you trust with your health. Those two decisions do not necessarily have to be tied together.
That distinction is especially important during Open Enrollment. You may be comparing deductibles, premiums, copays and networks right now. But this is also a wonderful time to ask yourself whether your current healthcare is actually working for you.
Can you get an appointment when you are sick? Do you know how to reach your doctor when you have a question? Do you feel comfortable bringing up the thing that has been bothering you for six months? Do you have enough time during your appointments to talk about more than one problem? Does your doctor know your history well enough that you don't have to start from the beginning every time?
And perhaps most importantly: Do you feel heard?
If the answer to those questions is no, changing insurance plans may not solve the problem. You may need to change the way you receive primary care.
In a traditional insurance-based primary care practice, physicians often care for very large panels of patients. Short appointments and packed schedules aren't necessarily because your doctor doesn't want to spend more time with you. They are often consequences of the system in which that doctor is trying to practice medicine.
Direct Primary Care changes that structure. At Deserving of Joy, patients pay a monthly membership directly to the practice rather than billing insurance for primary care. That allows me to care for a much smaller group of patients, and that changes almost everything.
New patient appointments are two hours because I want to hear the whole story. Follow-up visits aren't rushed. We can talk about your blood pressure, your sleep, your anxiety, your weight, your hormones and the weird symptom you almost didn't mention because you weren't sure it mattered. You can reach me directly when something changes. And over time, I get to actually know you.
That is what I believe primary care is supposed to feel like.
If you are considering Direct Primary Care, Open Enrollment is a particularly good time to think about it. Instead of asking only, “Which insurance plan gives me the lowest copay?” you can step back and look at your healthcare as a whole.
What insurance coverage do I need for emergencies, hospitalization, specialists, expensive medications and major medical care? What do I want my everyday primary care to look like? How much am I currently spending on premiums, copays, deductibles and other healthcare expenses? Would a different insurance plan make sense if my primary care were handled separately?
The right answer will be different for every person and every family. But you are allowed to ask the question.
People often start thinking about finding a new doctor only after something has gone badly. They couldn't get an appointment. They felt dismissed. Their symptoms weren't taken seriously. They left another rushed appointment without a plan.
But you don't have to wait for healthcare to fail you before deciding that you want something different.
Open Enrollment gives us a natural moment each year to look at what we have and decide whether it still fits. So while you're comparing premiums and deductibles this fall, I hope you'll consider one more question:
What would it feel like to have a doctor who actually had time for me?
Maybe you want to feel known. Maybe you want to know that when something goes wrong, there is someone you can reach. Maybe you want to walk into an appointment with your whole list and know that your doctor actually wants to hear it. Maybe you simply want a little more peace of mind.
Those things matter. Your relationship with your doctor matters. And you are allowed to choose healthcare that reflects that.
Because you deserve to feel heard, cared for and known. You deserve healthcare that makes room for you.
You are deserving of joy.
Dr. Kristy Mount, MD, PhD, FAAFP
Board Certified in Family Medicine and Obesity Medicine
Deserving of Joy
This newsletter is for general educational purposes only and is not intended to provide individual medical, insurance, financial or tax advice. Insurance coverage, HSA eligibility and individual healthcare needs vary. Please consult the appropriate qualified professional regarding your individual circumstances.