“Concierge Medicine”
February 11, 2007 | General
There are scholars that are saying essentially “that over time Americans would have less time and more money to deal with their healthcare (and lives as a whole)….based on the growth of income and wealth of high paid Americans verse the average.” As a result, we begin to see physicians clinics who are converting their practices into concierge services.(www.virginiamason.org) These services are many and varied types. They are focused around Primary care types of services. For example, Virginia Mason in Seattle, has creates a boutique practice where for $3,000 dollars a year, it offers individual subscribers 24 hour access to internists by Mobil phone or e-mail, as well as house calls and office calls by physicians. It has signed up 850 people.
Greenfield systems in Portland Oregon, for a mere $350 dollars per year offers similar services, which includes extended phone call and e-mail consultation plus the promise of an appointment the next day.
As we begin to see more and more providers create self payment systems, what does this say for the Consumer Directed Healthcare movement (HSAs). Will we begin to see a system where the deductible is fully in the control of the Consumer who has the ability to manage their healthcare and the system that delivers such? How will the HMO and managed care plans react to this? Is there a future for “Concierge Medicine”?
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Comment by Eileen Martinez February 14, 2007
This is the intuitive reaction of the marketplace to control of medicine by insurance companies and the government. I think it is a great idea. It brings back the relationship between the doctor and patient.
It is obvious that at this time these concierge services are available only to the
high income american. The great task for the providers is to make this available for the average American. Enter the HSA!
Comment by ConciergeDoc February 22, 2007
First to address cost:
1) In West Virginia, Dr. Vic Wood is leading a statewide pilot to provide a form of low cost concierge care to Medicaid patients.
2) At an average of $130 per month, is it truly that expensive. Especially when we consider what people use their disposable income for, to have the unlimited attention of a highly trained physician as YOUR private, tailored doctor - I think it’s the best ROI (return on investment) people can get in today’s crazy world.
Next: By alligning incentives, the concierge medicine practice truly re-establsihes the relationship between the patient and their doctor. While I’m starting to create my own practice, I spend a lot of time working extra shifts in hospitals. Let me say that in my 10 years in the hospital world, patients are not longer getting the continuity of care they desparately need. Too many PCPs defer full hospital care to the ER doc and hospitalist service, followed by some Rehab or nursing MD. And in the outside world, patients see way to many subspecialists for every problem. A typical patient age 65 might have a list of 4 doctros who provide some sort of care for him, plus if he’s in teh hospital for any reason, that number easily doubles. Who’se coordiniating this mess? Imaging how much more efficient medicine can be practice is one doctor corodinated care, prevent unecessary repetitive tests, well I could jsut keep going on and on and on. I welcome comments at my blog: http://www.myconciergedoc.com
Comment by Wayne M. Burr, MD May 4, 2007
My concierge practice is in Fort Myers, FL, and the feedback from the community and my patients has been positive.
I try to maximize what the patient is receiving for the concierge fee to include consultation with a dietitian, personal fitness consultation ans massage therapy. I enjoy the time that I am now able to spend with each patient personally overseeing their healthcare. Instead of delegating some of the responsibilities to the office staff for such things as ordering of diagnositic test and scheduling consultations with specialist, I am able to do these personally.
I agree with the comment that patients in this type of practice receive a better continuity of care just for the simple fact of the physician having more time. I know that others in concierge medicine are studying this fact and preliminary data would suggest that endpoints are improved such as a decrease in hospitalizations. I will be awaiting further data on this topic.
Wayne M. Burr, MD
Comment by ModernMed December 19, 2007
After exhibiting at the recent SIMPD (Society for Innovative Medical Practice Design) conference in Washington D.C. we have found that many physicians are frustrated with current state of primary care. As of Jan. 1st Medicare will be cut another 10%.
Where does this leave physicians that are already on roller skates with their patients? What will happen to these physicians when they cannot afford their overhead? Or worse, have the quality of their care hinder their exhaustion from seeing 40-55 patients a day.
With not many positive options for PCP’s we are proud to be an educator and facilitator for the movement of “retainer” or “concierge” practice models.
ModernMed is a forward-thinking health care service firm designed to create a better primary health care experience for patients, physicians, and businesses.
Unlike the competition’s models, we offer two extremely flexible practice solutions for the physician. While working with the physician to design the new practice ModernMed can assist in pre-conversion, during conversion, and post-conversion processes. Please visit our website for more information: http://www.ModernMed.com
Comment by Dr Andy April 3, 2008
I left a busy group practice in Fort Myers, Florida in 2005 to start my house-call based concierge practice. Originally I tried to deal with insurances but since none pay for house-calls, and Medicare only reimburses minimally, I couldn’t make it viable. In our area it’s not uncommon for me to drive 30-45min between visits and I typically spend 45-60min with a patient. Hence I was drawn to the concierge business model. I am still the ONLY concierge physician in South-West Florida exclusively making house-calls in Lee and Collier counties.
No mistake, my services are a luxury item and convenience for most of my patients. I charge $2000-$6000 a year per person, depending on age, size of family, and location.
I know it’s not the answer to our health care crisis, but I certainly love my job again! Besides I get to see my kids more.
2 other key points for the lay-person to understand. Just because I charge above what insurance pays, doesn’t make me rich. I actually made less than our city pays buss drivers for the past 2 years, although admitedly the potential is significant. Also, even though most of my patients are the “rich and famous” of our area, doesn’t absolve me or any concierge phsycian of our responsibility to the community. In fact this is a responsibility of each of my patients as well.
I continue to be an active office in the US Army Reserve, chair the Health Advisory Committee of the Lee County School District, volunteer as a Guardian ad Litem serving abused and neglected kids, teach Head Start program moms about child care, etc…
No, concierge medicine isn’t for everyone, but it certainly has worked for me and my patients.
Andrew Oakes-Lottridge, MD
Personalized Health Care, Inc.
(239)694-6246
http://www.DrAndy.us