Health watchdog monitors new care model

  • Membership-based care: general practitioner Henry Dowling of Associates in Integrated Health (File photograph by Jonathan Bell)
  • Tawanna Wedderburn, Bermuda Health Council CEO (File photograph by Blaire Simmons)

A health watchdog is to monitor the development of a new model of care in operation in at least three island clinics.

The Bermuda Health Council will assess how direct primary care could fit into the country’s healthcare system and whether it can play a part in reducing costs.

Tawanna Wedderburn, the BHeC chief executive officer, said: “The health council favours innovations that improve access and quality of care and reduce health costs.

“Direct primary care is new to Bermuda’s health system.

“The health council has to consider the wider implications and observe the health system impact to patients before determining what, if any, action may be required.”

Doctors using the membership-based direct model of care scheme said it offered a more personal approach with greater flexibility for patients.

People typically pay enrolment and monthly subscription fees that allow them tailored access to specific services.

Ms Wedderburn said there were three clinics on the island known to offer DPC, which is unregulated in Bermuda. They are Associates in Integrated Health, Ocean Rock Wellness and Burton Butterfield’s office.

Ms Wedderburn explained that DPC patients were still required to have health insurance cover for services such as diagnostic imaging, lab tests, specialist care, prescription medicines, hospital care and overseas care.

The BHeC has not set a time frame for its assessment of DPC.

However, Ms Wedderburn added: “The Health Council is collaborating with multiple stakeholders about how to reform Bermuda’s health system to cost less and deliver better health services.

“These reforms are likely to consider the role of direct primary care in Bermuda’s health system.”

The BHeC said this year that the cost of healthcare on the island was more than $700 million from April 1, 2015 to March 31, 2016.

Dr Butterfield is now introducing his patients to the possibility of signing up to a DPC scheme.

A notice at his practice announced: “This is an option whereby one can pay an affordable monthly fee to receive general practice service with unlimited office visits and no copay.”

He told The Royal Gazette: “Some people need care but they can’t afford to get it so I’m hooking up a different means for them to be able to get it.

“Direct primary care is not insurance, it may sound like insurance but it’s not.”

Dr Butterfield said patient fees would vary dependent on their needs and means.

Treatment provided by specialists is not included but Dr Butterfield said that if the volume of patients or funding allows, these could be considered at a later date.

Henry Dowling, a general practitioner at Associates in Integrated Health, delivered a presentation about DPC at the Bermuda Healthcare Services and Brown-Darrell Clinic’s quarterly Docs for Dinner event last month.

He said DPC was “a solution to our healthcare dilemmas”.

He adopted the new model in May and said a patient’s fee can be anywhere between $20 and $105 a month. The cost allows unlimited visits and access to Dr Dowling “after hours”, which he said could avoid some hospital emergency room visits.

Dr Dowling said there was no uniform model for DPC, which had become popular in the US.

He added that it offered flexibility and resulted in patients becoming more “engaged” in their health.

Dr Dowling said health insurance was “trying to be everything to everybody, and we are paying the price for it”.

He added that his membership-based model supplemented insurance.

Ayeesha Peets Talbot, the cofounder and medical director at Ocean Rock Wellness, said: “Moving towards a membership-based, direct-care model improves my access to my patients and allows me to achieve the best results possible. I love it and my patients do too.”

Ms Wedderburn invited members of the public to contact BHeC on 292-6420 to give their views on DPC.

A list of providers who accept health insurance coverage can be found on the BHeC website at