Family physician Jay K. Joshi discusses his article, "Why patients and doctors are ditching insurance for personalized care." He explains that as traditional insurance becomes less accessible and covers fewer proactive and preventive services, both patients and physicians are seeking alternatives. Jay outlines a direct-pay model, often focused on functional medicine approaches like metabolic optimization, hormone therapy, and advanced diagnostics, which strategically integrates financial planning into the care itself. This model utilizes tools like educating patients on Health Savings Accounts (HSAs), offering flexible payment plans through third-party financing, and implementing subscription-style payments for longitudinal care. Jay stresses the importance of empathetic, transparent communication about costs, framing them as investments and normalizing financial tools to reduce stress and improve adherence. He argues that such direct-pay structures empower patients, enhance clinical decision-making autonomy, and represent a vital evolution in health care delivery focused on accessibility and outcomes.

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