Do Not Blame Your Doctor For Going Concierge

Merrill Markoe’s reports that she was fired by her doctor in her article, ”My Doctor, the Concierge,” which was both sarcastically entertaining and painfully true. She writes a powerful commentary on the divide caused by insurance companies between doctors and patients. She is shocked at the rapidly growing trend of an access fee to see concierge doctor and yearns for the Hippocratic Oath’s “May I long experience the joy of healing those who seek my help.”

Nothing cuts the cord between the doctor and her patient like the mention of money. Yet, doctors all over the country are rushing to become “concierge medicine physicians.” The more you pay, the closer you can get to the doctor. For $1000 a year, you can be part of the club. Pay $2000 annually and you can have the doctor’s email. Pay $3000 and you can text or call her cell.

Our society expects doctors to be healers. Who doesn’t? But the Hippocratic Oath does not address the business of medicine, nor does it demand the physician to provide uncompensated care. The Oath is a covenant to provide the best care possible with dignity.

Society must remember that doctors have to pay back an average debt of $300,000 for 12 years of graduate schooling and not forget related opportunity costs. Medicine is the only business where every year the overhead increases while third party reimbursement diminishes. Moreover, a physician can work for thirty years and on her retirement, her practice is worthless.

There are also factors which affect cost of medical care over which doctors have no control. Insurance companies take some 30% of the healthcare dollars and provide no medical benefit. The FDA places so many restrictions on drug approval that it costs $1 billion to bring a drug to market. There are universities such as UCLA which take federal and state dollars to do research while setting up practices in the community, competing unfairly with private doctors and charging hospital rates for office visits. 10% of all gross receipts of any practice is spent collecting monies from insurance companies and patients. Doctors at their own cost purchase medical supplies and provide them to patients, risking denial of reimbursed by insurance companies.

There are also government mandates which increase costs to doctors. With the advent of Obamacare, there is increased cost of ensuring valid coverage, to receiving approval for treatment plans. Populating electronic health records (EHR) and generating meaningful use is time consuming with no reimbursement. Prescribing the most cost effective treatment in a litigious environment remains an oxymoron. Doctors, too, must ensure proper coding as not to leave a bad diagnosis on the patient’s chart that could affect his eligibility for obtaining life insurance, while picking a good enough diagnosis to be paid by the insurance company.

CMJ- Concierge Doctors are not creating the problem, they are working to revive a system that worked before the third party billing conspiracy deprived them of the power to deliver the care patients deserve. The concierge medicine movement will change the future of care and return us to a better time.


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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