Los Angeles Doctors Discuss Alternative Practice Models at AAPP Conference

Physicians News Network, April 1, 2013

As Obamacare is phased in, Los Angeles doctors, lamenting declining reimbursement rates coupled with greater overheads, are looking for alternative practice models.

The recent 2013 American Academy of Private Physicians (AAPP) conference in Palm Desert offered physicians a chance to compare experiences. After having been in solo practice for 21 years, Dr. Leonard Scuderi, a cardiologist in Torrance, said he was seriously considering making a switch to concierge or “direct pay” practice.

In concierge medicine, patients pay a monthly or annual fee for enhanced services, including same-day appointments, 24/7 access to their doctor, email consultations and longer appointment times. To make more time for patients, concierge doctors typically carry smaller patient loads.

Scuderi has practiced medicine for 19 years. In the last two years, with rapidly evolving healthcare reform, he has found that providing good patient care while maintaining a practice has become more difficult.

“I think with the state of the current healthcare system and the rapidly evolving Obamacare, with its increased regulations and simultaneous increase in overhead that’s required to meet those regulations, doctors are feeling like they’re drifting away,” Scuderi said.

Survey Shows Support for Concierge Medicine

He’s not alone. A recent survey of 13,575 physicians nationwide showed that 6.8% of doctors are considering switching to concierge medicine.

Nearly 8 percent of those surveyed were primary care physicians. In California 6.7% of doctors are considering a switch to concierge medicine, according to the survey conducted by Merritt Hawkins.

Concierge doctors who practice concierge medicine say it is more satisfactory, because they can practice the way they were trained, taking time to address patients’ concerns and using their skills fully.

Andrea Klemes, DO, medical director of the concierge medical group MDVIP, presented the results of the studies by MDVIP published in the peer-reviewed American Journal of Managed Care. It showed that this approach to primary care saved $2,551 per patient, due to decreased hospitalizations. It resulted in a 72% to 79% reduction in hospital readmissions for serious diseases, according to the study.

The number of concierge doctors is still relatively small, 4,400 in 2012, but it has risen by 30% in the past year. As Obamacare unfolds, Forbes’ magazine reports that as many as 10% of doctors are considering the switch.

The State of Healthcare

At the AAPP conference, presenters addressed the current state of healthcare and offered solutions to the growing shortage of physicians and the “shortage of health,” as Tom Blue, executive director, AAPP, put it.

Blue said the model of concierge medicine 1.0 had to do with access to care and the shortage of physicians. Model 2.0 is about moving from consuming health to creating health using new approaches and the latest technology as opposed to simply focusing on decreasing the number of patients per doctor.

Dr. Gary Price, president of AAPP, said the more efficient style of practicing medicine under the concierge model creates better results for patients and doctors. There has been no successful malpractice lawsuit against a concierge physician, according to Price, and it translated into lower insurance premiums negotiated for the AAPP members. He also said the concierge model of healthcare delivery, in his opinion, has moved into the mainstream.

It Takes a Team

AAPP presenters talked about the third era of medicine, where patients and physicians think of health as an asset and recognize that it requires team effort, time, and small incremental steps to manage it successfully.

“We are burning money chasing isolated symptoms,” said Blue. “We have acute care mentality.” The idea that we can scare patients into changing their lifestyle overnight, or that we can make doctors change their patients’ behavior if we penalize the physician for not producing a desired quality outcome, goes against human nature, he said. “Behavior does not change overnight just like chronic conditions do not develop overnight.”

Visit AAPP.ORG to find out the next conference schedule and information on joining.

Read Full Text from Physicians News Network

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About Concierge Medicine Journal

Concierge Medicine Journal (CMJ) curates breaking concierge medicine news, and editorial opinion on a wide variety of topics relevant to the practice of Concierge Medicine.

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