Belen Amat, MD became a doctor to help people. That's all that mattered. That's all she wanted. And fresh out of residency with that simple objective in mind, that's exactly what she set out to do when she signed on the dotted line and officially joined a large health care system serving the greater Grand Rapids area. Really, it was the only decision to make.
Up to this point, Doctor Amat's story is a common one.
Burdened by debt and feeling the need to establish a firm footing both financially and professionally, most young physicians choose to work within the confines of a large health system offering the kind of the salary, benefits and stability they feel they need early in their careers. Doctor Amat made that same choice. It is simply the path.
It just wasn't the right path for Doctor Amat, and she knew it almost immediately.
"Very early in my career, the disconnect between clinic administrators and practitioners became a source of frustration for me," Doctor Amat says. "Those handling the business side of things understand that office visits generate revenue, so they are always working to squeeze more and more appointments into the day, leaving us physicians with less and less time to interact with the patients we are trying to help. And seven to ten minutes with a patient just simply isn't enough time -- rushing like that doesn't lead to good outcomes for anyone. I tried my best to change our collective approach, but it was a losing battle and that really took a toll on me."
Dreading the start of every new workweek and feeling far too burnt out in her young career, Doctor Amat couldn't help but think 'there has to be another way.' And there was, but it would take some courage. She realized that if she hoped to escape the world of insurance-based medicine, she would have to cut her own trail.
And that's exactly what she did.
Six years into her career, Doctor Amat made the bold leap to direct primary care (DPC) in July of 2017 and she hasn't looked back.
An alternative to the traditional fee-for-service insurance-based model of care, DPC removes insurance from the equation. Instead, patients pay a flat monthly fee directly to their physicians in exchange for unlimited office visits, and discounts on labs, prescriptions and other services.
With roughly only 750 DPC practices across the country, direct primary care footprint in today's health system is still small, but its ranks are growing every day. And the reason for that is simple: providers and patients love it.
"Eliminating all the people in the middle between the physician and the patient makes such a huge difference in the quality of care that's delivered, and that isn't lost on patients," Amat says.
That sentiment comes as no surprise given the amount of attention and support DPC physicians can provide to their patients. On a busy day, Doctor Amat may see six to eight patients, which is a far cry from the immense patient load she managed while working for a large hospital system.
"I don't see as many patients as I used to, but I spend an hour with the patients I do have. And we talk about everything -- their life, their family, their goals. And establishing that real connection only leads to better outcomes. Really having a sense for what's going on in a patient's life very often helps me find the root of their malady, and then we work to effectively address that."
When she's not seeing patients in the office, much of Doctor Amat's time is spent managing issues remotely, usually over the phone, which is another perk of the DPC model.
"One of the big flaws with insurance-based care is the need to bring in the patient to get paid," Doctor Amat says. "That model of care incentivizes you to do as little as possible over the phone, and a lot of times, it's just not clinically necessary to see a patient in the office to make a diagnosis and proceed with a treatment plan. There's a lot that can be done over the phone, and that saves everyone time and money."
When she's not managing the care of her patients, Doctor Amat's time is spent promoting her practice and engaging in other areas that are important to her, including community education, delivering hospice care, and advocating on behalf of both doctors and patients.
"I've just recently stared to get more involved in MSMS, but it's quickly become a true passion of mine," Amat says. "The work they do fighting for doctors and working to promote an environment in which physicians can deliver the best care possible is important work, and I'm excited to get more engaged on that front."
Doctor Amat's advice for other physicians considering direct primary care: be brave.
"Before you jump in to DPC, it feels like you're about to hurl yourself off a cliff, but then you do it and you realize it's really more like hoping off a curb. Making the move is a scary thing to do, but you quickly realize everything is going to be fine. And it ends with you realizing it was totally worth it."