Dr. James Pinckney II is the CEO and Founder of Diamond Physicians, a membership medicine practice that focuses on the patient-physician relationship. Prior to creating Diamond, Dr. James studied general surgery at the prestigious Cedars-Sinai Medical Center in Los Angeles after graduating from Baylor College of Medicine in Houston. He switched from general surgery to family medicine in order to pursue his dream of transforming healthcare delivery in America. Dr. James completed his training in family medicine at Methodist Charlton Medical Center in Dallas. He is a board certified family physician licensed in the state of Texas and California.
In the last of our three-part series regarding the legal future of DPC and HSAs, Dr. James shares his experiences with the direct primary care model and what his hopes for the regulatory future of DPC in relation to HSAs and qualified expenses.
How long have you been practicing direct primary care, and what do you think have been the most significant changes (either in DPC itself or in how it is perceived) during that time?
I’ve been practicing DPC for 6 years, after formally establishing Diamond Physicians in 2012. One of the most incredible things about the direct primary care movement is the paradigm shift I have witnessed among physicians and consumers. Doctors are realizing that they don’t have to be handcuffed by the insurance system - they can free themselves from the shackles of a system that stifles ingenuity, price transparency, and entrepreneurship. The independent primary care physician is going extinct, and DPC is resurrecting the foundation of our healthcare system.
Patients, for their part, are realizing that they don’t have to wait two hours to see their physician for an appointment that may have taken six weeks to lock in. They don’t have to tolerate a poor patient experience that culminates with a prescription, no explanation, and a boot out of the door after 7 minutes of face time. “Concierge” medicine is no longer reserved for the rich and famous, but has instead become a viable option for the vast majority of Americans in the form of direct primary care.
What are the most ill-informed perceptions about DPC – either by others in the healthcare industry, employers, or patients – and how do you combat them?
We still battle the stigma that DPC is ‘concierge’ medicine – a high-priced retainer for access that still bills patients’ insurance for each and every visit, procedure, and lab drawn. DPC is so much more. By offering a capitated rate for unlimited visits and urgent care, tremendous discounts on labs and imaging, and 24-hour access to the doctor, you inject price transparency into the marketplace while bringing incredible value. I’ve been trying to convince brokers that this model will save our healthcare system, but employers have yet to readily accept the model. However, I do foresee that changing in the next year as Fortune 100 corporations like Amazon and Boeing adopt DPC as the predominant healthcare delivery system for their employees.
To combat the naysayers, we continue to do what we do best at Diamond Physicians: deliver exceptional care at an exceptional price. The industry has noticed. Brokers now come to us to learn more about DPC and we’ve expanded to four locations and eight physicians over the last two years, including a dedicated pediatric division that has been quite successful.
What impacts do you see on employee health through the use of a DPC model?
Think of the DPC as the ultimate wellness plan. The model engages the employee by connecting them with their primary care provider 24 hours a day. The physician implements diabetic coaching, weight management, exercise regimens, etc. We reverse chronic disease and hospitalization by 70% and reduce employers’ healthcare spend by an average of 20%. The vast majority of the time, our program more than pays for itself by year-two.
What impacts do you see on provider well-being and productivity when practicing a DPC model?
Physician burnout is at an all-time high. Sixty percent of doctors report experiencing burnout and more than 70 percent say they would not go into medicine if they had the opportunity to start over. DPC is a completely different story. The model alleviates physician burnout by allowing the doctor to have a fluid schedule, allowing for the use of flexible, telemedicine and communication tools; and, ultimately, helping doctors spend more time with their families and enjoy a higher quality of life
What drove you to become a DPC advocate, and to participate in the DC trip with the Accresa team?
I’ve been preaching the DPC gospel since 2013. I’ve staked my career on DPC, and anything I can do to get involved and contribute to the cause is an honor and a pleasure. The Accresa team has played an instrumental role in connecting employers to DPC physicians across the country. The more efficient and simple the process is for onboarding employees into DPC practices, the faster we can scale and deliver better care at a better price. That is exactly what Accresa allows DPC physicians to do and why I am so excited about the future.
What do you hope to see happen in relation to direct primary care legislation?
I would love for Democrats and Republicans to come together and create a bipartisan bill that fixes the Affordable Care Act (ACA). Get rid of the individual mandate (that had to be done via executive order). Strip down the provisions in the ACA that require unnecessary insurance coverage to be written into every plan (where, for instance, men pay for maternity coverage under some ACA plans). Allow the free market to drive insurance premiums down and provide outlets for Americans to consume healthcare at a fair rate.
One easy and logical first step would be to change current HSA regulations and allow Americans to use tax-deferred money to pay for direct primary care. Primary care is a medical expense -- arguably the most important medical expense there is.
Check out the other blog posts in this series:
- Part 1 – Advocating for DPC + HSA Legislation: A Recap of Our Trip to Capitol Hill with Donna Wilkinson, Legal Counsel, Ameriflex/Accresa
- Part 2 – Advocating for DPC + HSA Legislation: How A-1 Locksmith Took Control of Rising Healthcare Costs with Michael Schneider, CEO, Joe East Enterprises/A-1 Locksmith