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Direct Primary Care: A Bioethical Analysis and Discussion of Practice Characteristics
Fish, Erika
Fish, Erika
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Thesis/Dissertation
Date
2023
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Urban Bioethics
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DOI
http://dx.doi.org/10.34944/dspace/8459
Abstract
Primary care providers in the United States face many challenges that complicatecare delivery and contribute to burnout, including heavy administrative burden, large
patient panels,, and relatively low compensation when compared to other medical
specialties (Carlasare 2018). In response to these problems, alternate models of primary
care delivery have emerged. Direct primary care (DPC) is one alternate model of primary
care delivery that some think could provide a solution to problems affecting primary care.
DPC is a model of primary care delivery in which insurance is not charged for services
provided by a practice. Instead, patients pay a recurring membership fee in exchange for
access to services provided by the practice (Eskew and Klink 2015; DPC Frontier 2020).
While DPC may decrease physician burnout and provide a viable source of primary care
for some patients, there is the potential for DPC to contribute to already existing health
inequities. This thesis will explore characteristics of DPC practices in the United States to
identify qualities that could impact the delivery of ethical, equitable health care. These
qualities will then be examined through a bioethical lens using the principles of equity,
agency, and distributive justice to guide future directions for DPC and primary care
delivery as a whole with the goal of establishing a care system that serves patients of all
backgrounds and socioeconomic classes.
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