Wednesday, May 29, 2013

Concierge Medicine

Personally, I didn't have a lot of strong feelings about concierge medicine until my personal physician decided to convert his practice to it.

I do have VERY strong feelings about Obama Care speaking as a pediatric ER nurse. I tend not to get political here but, regardless of how you feel about the law, healthcare is changing in the US and physicians moving to concierge medicine is just one of them.

In the current state, physicians are worried about the feasibility of making a profit and keeping their practice doors open. Reimbursement is low-- particularly from insurance companies-- Medicare and Medicaid are prime examples. A doctor can only care for so many patients. So when money is cut they are required to see more patients to earn the same amount of money.

After a while, it becomes impossible to make the bottom line and provide quality care.

Concierge medicine is where the patient pays the doctor a fee for access or increased access. In my case, this was in addition to what we would pay for our regular medical insurance. What was the physician going to charge in our case? $1,800 per person. Just to see him. That didn't cover other diagnostics like lab and x-ray and likely an office visit fee.

In a letter he sent out, he was decreasing his practice from 2800 people to 400. Where will those other 2400 people go?

Realistically, the average American family is not going to be able to pay this type of money on top of their insurance premiums. What I see developing is a two-tiered medical system. A completely privatized, fee for service side and the government side-- unless changes are made to the current law.

What do you think of concierge medicine? Would you pay extra to see your current physician?


  1. Wow, Jordan, considering all of the medical issues my husband is facing right now, this is very, very scary! We think the world of our private physician and would probably pay to see him - if we could afford it! The amounts you mention here would be prohibitive for us.

  2. Here in Ontario we already have socialized healthcare (OHIP). It covers a lot of things, but not routine eye checkups for healthy adults between the ages of 20 and 64, nor dental care.

    When you said "concierge", I thought it meant like a hotel doctor or something.

    BTW, Jordyn, check this out if you're interested and able. It's an original series commissioned by TVO, our local public station.

  3. Oops! Forgot the link! The show's called "Hard Rock Medical"

  4. Several years ago the doctor we went to decided to do the concierge thing. He set up an informational meeting, printed flyers, all that. My husband went to the meeting, and said it seemed like it was mostly full of people who were angry with the doc for choosing this route. (And mostly older people on fixed incomes.) We knew we couldn't afford the fee (if I recall correctly, it was yearly.) I didn't actually see the doc, I saw his PA, and she was having a great deal of trouble with what she saw as the morality of his decision. Let me just insert here that she is the most incredible, compassionate, knowledgeable, amazing "doctor" I've ever had.
    So, what happened? Well, the doc decided to get a different PA and let my favorite one go. I left his practice and followed her. And in the end, the doc couldn't get enough patients to agree to go to the concierge model, so he ended up just continuing on with his normal practice (after losing a lot of patients -- although my husband stayed with him).
    As I said, I followed the PA to her new practice (even though it was much farther away), and a couple of years later followed her again as she moved to a different one back in our neighborhood.
    I think the concierge model stinks, personally. It's "quality medical care" for the rich. I truly hope this isn't where America is headed!

  5. Could not afford to do it even if I wanted to stay with my doctor.
    The hard part would be finding another doctor, we have so few good ones where I live.
    Wilma M.

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  7. Thanks for your comments ladies.

    I'm not a fan of this model either but physicians need to make money. Bottom line is we need competition and the government is not going to provide competition. It will just force everyone out through regulation.

    I agree that a lot of people aren't going to be able to afford this model to see a physician and it will be harder and harder to find one whose practice is not overwhelmed.

    Which, as always, leaves the ER's to pick up he slack-- the most expensive way we deliver healthcare.