Concierge Doctors: A Weird Concept
A friend of mine just told me she is using a concierge doctor. (It’s also sometimes called a VIP service.) I had never heard of it before. It’s a strange concept where you pay an annual fee ($1,500, $1,800, or higher) to a physician and in turn the physician limits the number of patients he or she has in the practice; promises 24/7 care, with same-day appointments; lots of ‘face time’ and lengthy appointments; house or workplace calls, if necessary; and all kinds of other warm, fuzzy things. (If the doctor is covered by your insurance, you will still have co-payments.) I think it sounds fabulous except that only people of means can fork over the annual fee. And doesn’t this create even lower expectations of all other medical care? Why should your HMO, for example, make an effort to get you an appointment sooner than six months from now when you could always opt out and get concierge care? Why shouldn’t all medical care be as personal and timely as so-called concierge care? Do you have any experience with concierge doctors? What do you think? From a Newsweek story:
But is this really the best medical care? Or is it an appeal to narcissism—luxury in medical trappings? Patients do benefit when docs take time to sit down and listen to them. (Would that we all got such attention.)
Here are a few stories about concierge doctors:
A Just Shoot Me Now take on concierge doctors
Concierge doctor from Milwaukee
A Bankrate.com review of the concierge doctor concept
The Newsweek story on The Blue-Chip Checkup
November 14th, 2008 at 12:26 pm
We have similar arguments in the UK, where people frustrated by the NHS can pay for private treatment which is usually speedier and more comprehensive. Same question – why can’t NHS care be just as good, why do people feel forced to go private to get proper attention? And the NHS makes less effort because all the people who should be complaining and putting pressure on them have simply gone elsewhere instead. Anything like this that creates a two-tier system only makes life worse for those who have to make do with the standard service.
November 14th, 2008 at 3:06 pm
I have to wonder what happens if/when someone goes over the annual fee in the number of visits. or if anyone keeps track of that.
November 14th, 2008 at 5:19 pm
Nick, good to hear it from someone who knows.
Jan: Good question. What if a hypochondriac joins a concierge service?
November 14th, 2008 at 8:22 pm
I agree that all health care should be like Concierge care, but it’s not going to happen under our current health care system. Doctors don’t spend all that time, effort and money going to medical school without there being a financial payoff in the end – not matter how altruistic they are.
Thanks for linking to my article!
November 14th, 2008 at 10:03 pm
I am very lucky that I have a doctor who believes in spending as much time as necessary with each of her patients. While I don’t always get same day appointments, and she is frequently running “behind schedule” I know that I’ll get her complete and undivided attention when she’s with me. I feel very lucky, particularly when I hear other’s horror stories. But these aren’t services I get because I pay more, there are just that I’ve got a good doctor.
I believe that everyone, regardless of income, should have access to good health care.
November 15th, 2008 at 1:28 am
As president of SIMPD, the Society for Innovative Medical Practice Design, the professional society open to all concierge and other direct practice doctors I want to confirm that the reason health care is so fragmented and disrupted today is the lack of excellent primary care America once had. That fact in large part results from the devaluation of primary care and its extremely low pay status under the third party and Medicare dominated payment system we now suffer under
The concept of “medical home” is a critical one. Every American needs one, a place they can access top notch primary care immediately and fully like one can access a concerned family member. And they need to buy that home directly, not with other people’s money. When they do so the cost can be very low to the patient and the benefits very high to patient, primary care doctor and society.
The only payer willing and able to pay what a medical home will cost is the patient. Interest in concierge medicine is therefore rapidly growing. Starting with the first such practice about twelve years ago in Seattle and growing exponentially, there are now thousands of such practices in the USA, some are associated with franchises though most are independent. No mater what the government does, that is where the action will be in the future as our numbers grow from the current thousands to tens of thousands to hundreds of thousands.
Direct practice doctors and those who wish to adopt the direct practice model can join the society and get many benefits including up to 55% discounts on malpractice insurance, practice marketing help, national care networks and many other services. Our society is rapidly growing its membership. Direct practice doctors have much more time with their patients, make a better living, and virtually never get sued. That is why we get huge malpractice insurance discounts.
Patients can go to SIMPD’s web site at http://www.simpd.org for information and to find such a doctor in their own community at the “find a physician” link. This is the ideal way for patients to get personalized, prompt, excellent primary medical care in a unhurried, pleasant setting. Money is actually saved on patient care in such practices because emergency room visits and hospitalizations are drastically reduced due to of the personalized, immediate, detailed care we deliver. The cost of concierge care, which averages about $150 per month, can be as low as $40 per month. This is affordable for most Americans, while the fragmented primary care most are now getting through employers or government third party interference in the doctor patient relationship is penny wise and pound foolish.
SIMPD believes most Americans can eventually be cared for in such direct “medical home” practices resulting in far better care. This will result in lower overall cost and a return of interest in primary care by students who now shun the field as undervalued, underpaid and undesirable compared with other medical specialties which for the same or lower levels of training and effort often pay double and tripple what primary care pays inside the insurance system.
If you have further interest please contact me through the SIMPD web site. I answer all emails through that site personally.
Thomas W. LaGrelius, MD, FAAFP President, SIMPD http://www.simpd.org
Owner, SPFC Torrance, CA http://www.skyparkpfc.com
November 15th, 2008 at 9:21 am
I find the entire health care system completely frustrating these days. I don’t think you should have to pay a fee to be treated in what should be the standard. I also don’t think that what passes for medical treatment today i.e., waiting months for an appointment only to have a doc spend 2 minutes with you, barely listening OR looking at you and then throwing some perscription at you should be tolerated either. Something MUST be done. I have lost all faith in this profession.