Doctor's office switching to "concierge" (additional cost outside of insurance)

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Concierge is a scourge.

It is ruining healthcare and making it so only rich people can afford medical care. USA is a third world S hole.

Concierge isn’t the scourge. Insurance companies + big pharma + private equity + Medicare legislation = the scourge. Concierge medicine is just a sign of it.

ACA also.

ACA is really just a subset of “insurance companies” here.

It really isn’t. ACA limits the price gouging by insurance companies, it doesn’t engage in it

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Concierge is a scourge.

It is ruining healthcare and making it so only rich people can afford medical care. USA is a third world S hole.

Concierge isn’t the scourge. Insurance companies + big pharma + private equity + Medicare legislation = the scourge. Concierge medicine is just a sign of it.

ACA also.

ACA is really just a subset of “insurance companies” here.

It really isn’t. ACA limits the price gouging by insurance companies, it doesn’t engage in it

It is. The ACA was the government getting into bed with the insurance companies as a compromise to (politically impossible) single payer. I will assure you the insurance companies more than made up for any limits on price gouging.

[Anonymous]

Anonymous wrote:Email:


Dear {insert patient name},
[sic. That's what the email said]


We are writing to announce an important practice change. We will convert to a concierge/personalized care practice model.

Unfortunately, in recent years the healthcare environment has made it almost unsustainable to practice medicine as independent physicians due to the mandated constraints placed on doctors.

Continuity of care and personalized communication have become more difficult. This is not the way we want to practice medicine.


As a member, you will enjoy phones answered live by caring staff, scheduling appointments quickly and at your convenience, having extended unhurried visits, receiving dedicated follow-up between visits, and directly communicating with us after hours for urgent issues.


In order to realize these goals, our practice size will be limited and there will be an annual membership fee
------

Fee amount not announced yet.

Thoughts?

Sounds like a lot of words to say "we need more profit per patient."

So now we get a guaranteed fixe price to pay PLUS still get surprise bills for treatment.

How much is the annual membership fee?

[Anonymous]

Anonymous wrote:

Anonymous wrote:I’m surprised that you’re surprised by this. Over the past 5 years lots of PCPs have moved to a concierge model. My doctor explained that she would now be able to see 400 patients instead of the 2200 she was previously seeing. It’s up to you to decide whether the premium is worth it. My doctor still took my regular insurance so there were no surprises there.

I decided it wasn't worth it. I see several specialists for a complicated condition and a PCP doesn't add much value, especially for $2200. I'm not sure what they're going to do during the superduper annual check up. They certainly do not coordinate the specialists, and when I was diagnosed the PCP knew less about the condition than I did from Dr Google.

My suggestion would to find a PCP who uses the same portal as your specialist. Having them share records is the best care coordination for me.

Where did you get the $2200?

The PP said her doctor is able to see "400 patients instead of the 2200 (patients)" now. No one said the annaul membership fee is $2200.

[Anonymous]

If every practice moves to concierge then where will the masses go?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Thank ACA.

This isn’t an ACA thing. It’s a privat insurance thing.

I would MUCH rather have a government bureaucracy making decisions about my health coverage and claims than a private enterprise trying to meet quarterly earnings targets.

Oh my God. You have obviously never worked with the government.

My mom was a VA nurse for 38 years. You do NOT WANT THE GOVERNMENT MANAGING YOUR CARE. So many unnecessary deaths due to poor docs. There was one surgeon they called "Dr. Death" because he nicked organs like weekly, leading to people dying of sepsis unnecessarily. Did the VA stop him from operating? Nope. He continued on for 15 more years doing this until he retired.

Same in private insurance care.

It’s not nearly as bad. It’s all fine to say it’s the same until it is your family member who dies at the hands of a butcher. This doc was kicked out of private practices. No doc chooses the VA

So if it was that blatant and that obvious, why wasn't he reported to the medical board? Why wasn't he sued, if there was a visible trail of carnage behind him? FTCA allows patients to file claims of negligence against the VA to receive compensation for economic losses and suffering. You can't tell me you can't find a lawyer to file a suit that would be an easy win.

This does not meet the smell test.

[Anonymous]

Anonymous wrote:Blame the insurance companies.

Or rather insurance CEOs who need another yacht.

Or rather government that won't regulate this abuse

Or rather Republicans who oppose single payer

Actually, blame Medicare and Medicaid, which pay rates that are so low that doctors lose money on each visit. The rest of us are charged to subsidize these visits. Concierge practices are a way to move away from accepting government funded patients (because, yes, the government limits the maximum charge for M&M). And you are very uninformed if you think your life will be better under a single payer system (unless you currently have no insurance).

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I’m a doctor in primary care. If you want an MD pcp doctor in the future with good appointment times and someone who has time to listen etc this is what the future holds. For many it’s either this or leaving medicine all together because the current landscape is not sustainable.

In the future it will be either MD via concierge for the rich and a rotating group of NP/PA with less training for everyone else.

nah, we dont want to pay and think $50 for a annual PCP visit is more than enough SMH at how brainwashed the patients/consumers are these days.

$50 is more than enough. It’s shocking how brainwashed Americans are. People on South Korea or Japan go to the doctor every year for free, or when they need to pay it costs something like $5-10 per visit. US healthcare blows.

You don't understand the difference between how much the patient pays at point of service vs how much the provider receives.

And you don’t understand how terrible the U.S. is. The Japanese have a similar level of taxation as we do, yet somehow they manage to have pretty much universal access to affordable medicine. In fact, the Japanese government mandates that everyone get a free comprehensive physical every year after a certain age. Healthcare is affordable and accessible there that they got to the doctor like 9-12 times per year, on average. Each time might only cost them $20 or less out of pocket.


Meanwhile, in the U.S. we shell out hundreds per month for insurance that many places no longer even take only to have to pay even more exorbitant fees at the offices. And that’s only if you’re lucky enough to get access to a doctor. Everything about US healthcare blows. It is massively overpriced too.

Because doctors (and drug/insurance execs) expect to be rich.

For all of their complaining, do you have one doctor friend:relative who is not well off? They live in nice houses, send kids to private school, go on fancy vacations.

Lately, some don’t even work five days a week.

If you can afford that lifestyle, while working part-time, you are over charging your patients.

After spending years in training and going deep into debt. Sure.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Thank ACA.

This isn’t an ACA thing. It’s a privat insurance thing.

I would MUCH rather have a government bureaucracy making decisions about my health coverage and claims than a private enterprise trying to meet quarterly earnings targets.

Oh my God. You have obviously never worked with the government.

My mom was a VA nurse for 38 years. You do NOT WANT THE GOVERNMENT MANAGING YOUR CARE. So many unnecessary deaths due to poor docs. There was one surgeon they called "Dr. Death" because he nicked organs like weekly, leading to people dying of sepsis unnecessarily. Did the VA stop him from operating? Nope. He continued on for 15 more years doing this until he retired.

So much misinformation. First, ACA isn’t govt run healthcare, it’s through private companies. Second, I’m sure the VA has problems but Medicare is govt run healthcare and seniors are overwhelmingly happy with original Medicare. There’s no reason that model couldn’t work for more people. Third, you have to talk about the impact private equity has had on practices.

Can we actually talk about this? It should be perfectly transparent when a practice is owned by PE. Because I would immediately walk.

There is no symbiosis to those sharks buying up practices (who is selling to them) and patient care.

No, Medicare is government PAID health care, which is totally different than government run health care. And seniors may be happy with their original Medicare, but that's because there are basically no limits on their expenditures AND the rest of us subsidize the low rates paid by the feds to hospitals and physicians. That is not a sustainable model for the entire system.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Insurance premiums aren’t some magic fairy money that pays your docs. For the most part they (insurance cos) do their best to not pay or set the rates of services so low that docs are not being paid well - and sometimes not much at all beyond the copay. The concierge model helps the docs manage their practice in a way to be available to you more readily and not get completely hosed by the insurance company. If everyone took up the nonpayment more with their insurance companies instead of complaining to the doctors offices about this, it would have more traction. We all need to take more responsibility and understanding our benefits and how they work. The reason there are surprise bills are because the insurance company has a set point for your care. It’s your responsibility as a consumer to check in on your plan.

+1

Concierge docs are worth all the $$$ if you can afford it. You get 24 hour access for texting/Calling. They always have a "sick/same day consultation" available---may not be your doctor, but at least one in the practice will have space. They help arrange appointments/get you in earlier if you have issues and need more care. They coordinate care. They actually know you because most have 25-30% of the patients a typical doctor has, then they stop accepting new patients.

When I call the regular number for our concierge system, I always get a live person (or leave a message and get a response in an hour). no leaving a message and waiting until the next day for a response. The $200-300/month fee is to allow the doctor to see less patients. You get a 30-45 min appt most of the time, not 10 min.

My mom tried a concierge doctor - they eventually booted her because they said she wanted too many visits (she took up too much of their time). And frankly, they gave crappy service. I wasn't convinced they actually had her best interest at heart. All they wanted was healthy patients.

They also want overweight/ obese patients with abnormal lipids to give them statins, Ozempic, and a cocktail of other candies from the pharm companies that feed their bank accounts.
They don’t like patients who decline those crappy pills and ask questions that require them to think a bit deeper.
I finally kicked the PCP and the whole team to find better care somewhere else.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Insurance premiums aren’t some magic fairy money that pays your docs. For the most part they (insurance cos) do their best to not pay or set the rates of services so low that docs are not being paid well - and sometimes not much at all beyond the copay. The concierge model helps the docs manage their practice in a way to be available to you more readily and not get completely hosed by the insurance company. If everyone took up the nonpayment more with their insurance companies instead of complaining to the doctors offices about this, it would have more traction. We all need to take more responsibility and understanding our benefits and how they work. The reason there are surprise bills are because the insurance company has a set point for your care. It’s your responsibility as a consumer to check in on your plan.

+1

Concierge docs are worth all the $$$ if you can afford it. You get 24 hour access for texting/Calling. They always have a "sick/same day consultation" available---may not be your doctor, but at least one in the practice will have space. They help arrange appointments/get you in earlier if you have issues and need more care. They coordinate care. They actually know you because most have 25-30% of the patients a typical doctor has, then they stop accepting new patients.

When I call the regular number for our concierge system, I always get a live person (or leave a message and get a response in an hour). no leaving a message and waiting until the next day for a response. The $200-300/month fee is to allow the doctor to see less patients. You get a 30-45 min appt most of the time, not 10 min.

My mom tried a concierge doctor - they eventually booted her because they said she wanted too many visits (she took up too much of their time). And frankly, they gave crappy service. I wasn't convinced they actually had her best interest at heart. All they wanted was healthy patients.

They also want overweight/ obese patients with abnormal lipids to give them statins, Ozempic, and a cocktail of other candies from the pharm companies that feed their bank accounts.
They don’t like patients who decline those crappy pills and ask questions that require them to think a bit deeper.
I finally kicked the PCP and the whole team to find better care somewhere else.

They must have been so distraught at your leaving.

[Anonymous]

Statins are generic. 30 pills at less than 50 cents each is under $15 a month.

Yeah, you busted that big payback scam.

[Anonymous]

Anonymous wrote:If every practice moves to concierge then where will the masses go?

oncologist

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I’m surprised that you’re surprised by this. Over the past 5 years lots of PCPs have moved to a concierge model. My doctor explained that she would now be able to see 400 patients instead of the 2200 she was previously seeing. It’s up to you to decide whether the premium is worth it. My doctor still took my regular insurance so there were no surprises there.

I decided it wasn't worth it. I see several specialists for a complicated condition and a PCP doesn't add much value, especially for $2200. I'm not sure what they're going to do during the superduper annual check up. They certainly do not coordinate the specialists, and when I was diagnosed the PCP knew less about the condition than I did from Dr Google.

My suggestion would to find a PCP who uses the same portal as your specialist. Having them share records is the best care coordination for me.

Where did you get the $2200?

The PP said her doctor is able to see "400 patients instead of the 2200 (patients)" now. No one said the annaul membership fee is $2200.

Marshak's office sent out a very, very similar email (probably coordinated through Privia), and their fee will be $2200/person.

[Anonymous]

Anonymous wrote:If every practice moves to concierge then where will the masses go?

Kaiser will get a lot more popular until insurance companies correct and negotiate away from the fee. BCBS/Carefirst could stomp this out quickly if they wanted to. There's certainly a market for out-of-network providers, but it is a small one.