Do any psychiatrists practice with a model similar to "Direct Primary Care"?

[Mad Jack]

I mean I bet I have between 400-500 active (so seeing at least every 3 months) patients at any one time. I do 4 new intakes a week, so say 26 hours of followups a week x2= 52 x4= 208. Certain proportion are going to be every 3 months, some proportion are monthly for a while so call it every 2-3 months on average, so prob somewhere north of 420+ people who are regularly following up at any one time. I also have a handful of college kids I just see back on breaks.

No one is going to pay you this kind of money for a singular visit every 2-3 months though

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[clozareal]

I was more talking about a clinic with wraparound services for families with adult (or teen I guess) kids with IDD/moderate to severe ASD, not just a straight DPC clinic for primary psych issues. Frankly, these patients/families probably need a CMHC where they can get solid case management, but unfortunately ime a lot of the CMHC programs have poor experience/care for adults with IDD, so those families end up flailing even with that support. No way a DPC model could serve that community charging only $300-400/mo, it would have to be significantly more. I was just saying that I've met plenty of families that would be more than willing to pay $1k/mo to get good care for their IDD adult children.

Agreed. I see plenty of ID and ASD who need a lot of support. Luckily in my area there is a state-funded department that provides case management to help with employment, residential care with support, in and out of home respite for parents, adult day services, transportation, adaptive equipment. I think that's probably why it's not available yet.

I interviewed for a job that was an autism center that had neuropsychologists, individual therapists, family therapists, occupational therapists, physical therapists, case management, educational therapists, neurologists, gastroenterologists, sleep medicine docs, dentists, barbers, a toileting clinic, and a challenging behavior consultation for self-injury. It was funded through a donation and is a nonprofit but the funding stream also comes from the children's hospital and state medicaid managed care as well.

There's another clinic in my area that does neuropsych testing, educational therapists, ABA therapists, family therapists, and developmental behavioral pediatricians for ASD and ID but no psychiatrist. They are cash only.

I think these sorts of models are fantastic. One of the biggest values of psychiatry is spearheading multidisciplinary care and solo private practice is the opposite of that. If you can get everyone under one roof communicating and providing care, I think that should be the gold standard of care for psychiatry in the future.