Dare To Start Making Decisions Based On Your Health, Not Your Financial Status

By Lisa Brody

02/04/2014 – Our lives are ruled by sets of transactions and the choices we make. When we want something to put on our feet, we can shop at Payless for passable black shoes. Or we can head on over to Neiman Marcus for a pair of Prada pumps or black loafers. In need of a cup of joe? There are lots of choices. You can make a quick cup of instant, or a steaming pot of your favorite brew. New single cup coffee brewers, such as Keurigs, are now part of the options. And then there are coffee shop selections, from Starbucks to Biggby to Tim Horton’s and Dunkin’ Donuts.

In today’s world, health care is also ruled by sets of transactions, from eligibility to reimbursement of coverage. It has become a system often ruled by financial decisions, rather than medical considerations.

Some physicians and patients are choosing to seize their health care back from insurers and the government through a series of independent transactions with doctors of their own choosing who offer personalized care. It’s called concierge medicine.

Concierge medicine is a relationship between a patient and a primary care physician where the patient pays the doctor an annual fee or retainer in exchange for enhanced personal medical care, including 24/7 access to the doctor via cell phone and e-mail, no waiting for visits, electronic medical records, and even visits to the patient’s home or office. While patients who are electing this kind of care rave about the advantages, detractors warn about the dangers of a two-tiered health care system developing in the United States.

Once upon a time, health care consisted of visiting your family doctor for everything from pediatrics to geriatrics, and just about everything in between. He delivered your baby, saw it through well visits and the croup, watched your kids grow up, and eased you through middle age and into your waning years. Like Marcus Welby MD, he (because there were few female physicians) was available when you and your family

were sick, coming into the office whenever needed, and even making house calls. He was practically part of your family.

Of course, Dr. Welby never discussed payment. Because one, that was TV. Second, it was in another era.

In today’s health care system, with the implementation of the Affordable Care Act (ACA), also known as Obamacare, with its pros and cons, many more people will have access to health care (a pro), there are others who feel more like a number than a patient (a con).

As the ACA is phased in, health experts believe there will be a critical primary care physician shortage, with primary care doctors – internists, general practitioners, family practice doctors, geriatric specialists – retiring early, specializing, or even moving out of medicine altogether as insurance reimbursements become even tighter. The Wall Street Journal forecasts an expected shortfall of 60,000 physicians in 2015 and 90,000 by 2020, which is roughly 10 to 15 percent of all practicing physicians, even as millions of newly-insured patients enter the system. The likely result of these physician shortages? We’ll likely experience longer waits for doctor appointments and less time with our doctors when we actually get in to see him or her.

“Because of declining reimbursements, primary care physicians will be forced to see as many as possible each day in hurried 10-15 minute appointments, simply to make ends meet,” Paul Hsieh wrote in Forbes magazine in March 2013.

Neither patients, nor doctors, enjoy being a number, spending more time in the waiting room of a doctor’s office than with the doctor themselves. In an effort to reclaim their practices, some primary care physicians are transitioning their offices to concierge medical practices, where the emphasis is on personal care. It all comes with a price tag, which some patients are more than willing to pay. In exchange, concierge physicians carry smaller patient loads, usually around 500 patients, rather than the usual 2,000 to 2,500 patients of an average primary care physician. The price can average around $200 a month, where in exchange the patient will obtain a personal physician on call 24/7; house calls; no waiting in a typical crowded doctor’s waiting room; unlimited appointments; complete physical exams; wellness, fitness and lifestyle screenings; weight management; nutritionists; lab tests; x-rays; coordination if you become ill while traveling; mental health checks; well-baby checks; acute care visits; online access to medical records; home delivery of medication; hospital visits from the doctor; transportation to appointments, if needed; coordinated care with specialists; and even hotel reservations for your family during a medical crisis.

Concierge medicine is a relatively recent innovation for medical practices. It’s believed to have been the brainchild of the former team doctor for the NBA’s Seattle Supersonics, who after seeing firsthand the excellent level of care professional athletes were receiving, decided to provide the same kind of services to non-athletes. He founded MD2 (pronounced “MD Squared”) in 1996 in Seattle. The idea resonated both with physicians who felt overworked and understaffed, and patients seeking a more “Ritz Carlton-like” level of service and care from their doctors.

“We recognized back in 2000 that health care was moving from personal to a more institutionalized form, and it wasn’t what we wanted to do,” said Dr. John Blanchard of Premier Private Physicians, a concierge medicine practice with offices in Troy and Clarkston. “We felt we needed to have time with our patients, to have the excellence to have the time with patients. Health care has been cutting reimbursement to doctors, which has forced doctors to see more patients, so the time doctors have with their patients have declined. The average time today with patients for most doctors is only 10 minutes.”


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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