"The pace of healthcare has gotten to the point where it has begun to strip the consumer perception of quality down to the bone," he says. "In an environment where the physician relationship is scarce free market principles would suggest that people who value that relationship are now looking for alternative ways to secure it for themselves."
"For people responsible financially for their own health with high-deductable plans there is a growing appreciation for the value of preventive care and staying healthy as opposed to reacting when you are sick," he says.
"The economic value of preventive care is beginning to increase in the minds of the consumers because of the financial responsibility."
Blue says self-insured companies are already seeing the value of hiring private practice physicians to provide on-site primary care for their workers. "Making care more accessible and convenient reduces hospitalizations and specialized care. It's a formula that is playing out conclusively and we are seeing more companies that want to take control of that relationship," he says.
For physicians who are sick of the hassles around practicing medicine, Smith says direct pay may be the perfect remedy.
"It's the easiest way for a doc to go off the grid," he says. "I've heard people describe it as a bit of a time warp. You get to go back 30, 40, 50 years and remove the insurance hassles from your practice and have this practice of 600 patients or so that you handle."