Concierge Medicine

[Anonymous]

Anonymous wrote:I am so opposed to this trend.

They are charging you a retainer to be their patient.

Trying to work less and make more.

Cutting out all but wealthy patients..

Reeks of greed, but around here they can get away with it.

I hate the trend too but I don't blame the Drs. They are made to spend a ton of time on insurance and back-office stuff and the reimbursements are low for how much training and expensive education they have gone thru. The system is really broken and this is a symptom of it.

[Anonymous]

I have been long opposed to this, but twice in the six months I couldn't get in with my doctor or NP when I had pressing but not emergency concerns. It's making me reconsider, because if I'm going to have to go to CVS or urgent care for sick visits anyway, the cost of a less-expensive concierge would at least buy me the consistency of seeing the same provider each time.

[Anonymous]

Anonymous wrote:I am so opposed to this trend.

They are charging you a retainer to be their patient.

Trying to work less and make more.

Cutting out all but wealthy patients..

Reeks of greed, but around here they can get away with it.

I don't agree. On a lot of fronts.

First not just here but it is everywhere and it is the future. I think it will not be too long before other practices require 500 to join.

Doctors are not trying to make more. In most cases they make less. But they can spend more time with patients.

[Anonymous]

Anonymous wrote:They keep using the excuse of insurance companies but many providers refuse to deal with them even before going concierge (i.e., they make the patient pay in full at time of service, and have to hound the company for reimbursement). So, that is BS.

I have a bunch of doctors and have never even heard of this -- you must be out of network for your insurance.

[Anonymous]

The conclusion seems to be that there are good and bad doctors, some of whom are concierge and others that aren't. If you don't get value out of your current doctor look elsewhere. Look at washingtonian or consumer checkbook for recommendations. Online reviews are typically garbage but neighborhood recommendations might help as well. If your current doctor is hard to schedule with, contact, etc then maybe consider concierge. If your current concierge doctor isn't living up to their promises find a different one.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I am so opposed to this trend.

They are charging you a retainer to be their patient.

Trying to work less and make more.

Cutting out all but wealthy patients..

Reeks of greed, but around here they can get away with it.

I'm OP and the thing is, I'm not wealthy. This would be a big financial sacrifice.

Doctor here. I am not a concierge doctor but it makes a lot of sense to me. The fee covers all the work doctors have historically been unfairly asked to do for free (and for which other professions, like lawyers, charge by the hour and much more): phone calls, talking to pharmacies, arguing with your insurer, completing disability and other forms, consulting other doctors we know, and more. In addition these are some diseases and some patients that require a lot of hand holding and are very labor intensive. There are still others who are entitled and expect to be treated as the exception and like VIPs. For all these people, concierge medicine is appropriate. And frankly, knowing what goes on behind the scenes, and how difficult access is right now PSLF-COVID, $2K annually is a bargain in these times.

+1

Would much rather skip eating out 3-4 times per month and pay the $250 for better service/care and a doctor who is not rushed and overworked. We think it is worth the cost and realize that insurance sucks and doctors do not get paid much relatively speaking, hence the 5-6 appts per hour.

When my kids were little (15 years ago), the Ped would charge $120 for a well baby visit, and our insurance would pay $35--the negotiated rate. So $35*4=$140. $140/hour for the nurse responsible for you, the front desk staff, the IT staff, the office costs and HVAC/utilities, and the doctor and their malpractice insurance, etc. In the grand scheme they are NOT making very much for their education levels.

Except many concierge practices do not do these things. I've been a patient at Foxhall Internists, and I can guarantee you they are not calling pharmacies or arguing with insurers. Most concierge docs like FH won't even take insurance or even Medicare. So, you are paying out of pocket AND paying a yearly retainer.

As far as "coordination," my experience has been that when something is hard, they give you a referral to a specialist just like any other doctor would give you. I have filled out so many hipaa forms but my concierge doc has never actually picked up the phone to discuss my condition, disease, etc. with another provider (even when she said she would because it was so serious). The more money they make, the less they work for you. Concierge is like an income floor that is super high-takes away any incentive.

It’s safe to say you don’t know what they do.

She knows what they don’t do.

Thank you, PP! I am obviously referring to my experience, as I indicated above. The dismissive poster is too thick-skulled to read. Probably works for Foxhall or MDVIP.

When I follow up and ask my pcp, "Did you have a chance to speak with so and so? I filled out the hipaa form." My concierge doc says "nope, sorry." So, I absolutely know they did not do what they said they would do.

And they obviously are NOT calling insurance or pharmacy because as I stated, my concierge doc makes you pay out of pocket.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Not in the DC area but my nephrologist just moved to a concierge practice. They accept no insurance. He said he could no longer deal with not having enough time for his patients and being micro managed by a big corporation. He was apologetic but said he has to make decisions about his career that are best for his family and that allowed him to give his patients the kind of care all should get.

I can't follow him because I can't afford it. It is definitely elite healthcare for those with money.

I understand, but this also means patients who can’t afford it aren’t getting care at all.

I would have followed him if I could afford it but I can't. He assured me I would get good care from among the several docs in the practice he was leaving even though he doesn't want to work there anymore. So I will get care but possibly not at the level I got from him. He literally treated me as if it was already a concierge practice, very thorough, never rushed, called me himself to give me test results, excellent care. I miss him already.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Not in the DC area but my nephrologist just moved to a concierge practice. They accept no insurance. He said he could no longer deal with not having enough time for his patients and being micro managed by a big corporation. He was apologetic but said he has to make decisions about his career that are best for his family and that allowed him to give his patients the kind of care all should get.

I can't follow him because I can't afford it. It is definitely elite healthcare for those with money.

I understand, but this also means patients who can’t afford it aren’t getting care at all.

I would have followed him if I could afford it but I can't. He assured me I would get good care from among the several docs in the practice he was leaving even though he doesn't want to work there anymore. So I will get care but possibly not at the level I got from him. He literally treated me as if it was already a concierge practice, very thorough, never rushed, called me himself to give me test results, excellent care. I miss him already.

This is how I practice too. To me concierge makes sense bc it is a business model that allows me to practice the way I want to and was trained to instead of the factory worker model high volume practices have taken on to cope with decreasing reimbursement rates from insurers and Medicare.

[Anonymous]

We may for Concierge (Inova 360) for my husband. It’s been a significant improvement for us as he has several medical issues and the Internist coordinates care. We are very pleased with the ~$2k/yr expense. Insurance is submitted, but not for the yearly fee. Physicals and problem visits get submitted to insurance.

My internist has a partial concierge practice. I don’t participate because (1) I haven’t had an issue getting appointments when I need them and (2) I get some of my care at Walter Reed and the civilian concierge doc wouldn’t be able to coordinate that.

[Anonymous]

Anonymous wrote:I am so opposed to this trend.

They are charging you a retainer to be their patient.

Trying to work less and make more.

Cutting out all but wealthy patients..

Reeks of greed, but around here they can get away with it.

You aren't wrong but I will say that most doctors are pretty awful these days (likely because of evil insurance companies but they play right along so I attribute some fault to the drs too).

My mother has cancer and waited over a week for her GP to call back for urgent requests related to chemo issues or prep for procedures. Luckily her oncologists step in most of the time and help but she's technically supposed to work with her GP on these things.

When she had pneumonia as a cancer patient, she waited 2-3 days to see her doctor. They forgot to send her prescription to the pharmacy and it took another 2 days to get a call back. Then they didn't call it in again.

It's not just a full time job dealing with doctors these days, it's a lot of anxiety and puts us all at risk to delay care this much.

We are all now at One Medical. The fee is ridiculously small ($150 for the first year). You get a full 30 minute appointment. They do not rush you. You can discuss more than one issue if needed.
They have a lab on site (they do send it out so results are not fast but the process is easy)

The system is broken because one political party seems to think suffering is just part of being an American. I guess that's their idea of freedom.
I vote, I write letters and I appeal the greedy insurance company's denials. I also complain to the Maryland Insurance Commission when I know decisions are wrong.

Until Americans realize they could have decent health care if they actually voted for it, we are in this mess.
We are a high income family who does not spend a lot of money in general. A concierge doctor brings me peace of mind that is really worth it. For the cost of one massage, I get access to quality healthcare! I don't go to Starbucks or get my nails done or go out a lot. This is where I want to spend my money. My anxiety is so much lower. Previously I saw a therapist to discuss my anxiety about not getting the healthcare I needed.

When I had Kaiser, I had to spend hours begging for appointments and then drive for 40 minutes to get to a random dr. Now I call and get same day or next day appointments and drive 5 minutes to see my dr. I can email them or have a video visit 24/7. I've never waited more than 3-8 minutes for access to a dr.

Don't knock it until you try it!

[Anonymous]

Anonymous wrote:

Anonymous wrote:I am so opposed to this trend.

They are charging you a retainer to be their patient.

Trying to work less and make more.

Cutting out all but wealthy patients..

Reeks of greed, but around here they can get away with it.

You aren't wrong but I will say that most doctors are pretty awful these days (likely because of evil insurance companies but they play right along so I attribute some fault to the drs too).

My mother has cancer and waited over a week for her GP to call back for urgent requests related to chemo issues or prep for procedures. Luckily her oncologists step in most of the time and help but she's technically supposed to work with her GP on these things.

When she had pneumonia as a cancer patient, she waited 2-3 days to see her doctor. They forgot to send her prescription to the pharmacy and it took another 2 days to get a call back. Then they didn't call it in again.

It's not just a full time job dealing with doctors these days, it's a lot of anxiety and puts us all at risk to delay care this much.

We are all now at One Medical. The fee is ridiculously small ($150 for the first year). You get a full 30 minute appointment. They do not rush you. You can discuss more than one issue if needed.
They have a lab on site (they do send it out so results are not fast but the process is easy)

The system is broken because one political party seems to think suffering is just part of being an American. I guess that's their idea of freedom.
I vote, I write letters and I appeal the greedy insurance company's denials. I also complain to the Maryland Insurance Commission when I know decisions are wrong.

Until Americans realize they could have decent health care if they actually voted for it, we are in this mess.
We are a high income family who does not spend a lot of money in general. A concierge doctor brings me peace of mind that is really worth it. For the cost of one massage, I get access to quality healthcare! I don't go to Starbucks or get my nails done or go out a lot. This is where I want to spend my money. My anxiety is so much lower. Previously I saw a therapist to discuss my anxiety about not getting the healthcare I needed.

When I had Kaiser, I had to spend hours begging for appointments and then drive for 40 minutes to get to a random dr. Now I call and get same day or next day appointments and drive 5 minutes to see my dr. I can email them or have a video visit 24/7. I've never waited more than 3-8 minutes for access to a dr.

Don't knock it until you try it!

Do you mind sharing the name of your PCP?

[Anonymous]

When people here say their concierge doc "coordinates care," what does that actually mean? Serious question.

I have been in the traditional system, and if I need to go to a specialist, my pcp gives me a rec. for a provider/practice. I then go to said specialist and either tell my pcp how it went at my next appointment with her, or the specialist sends the results/lab work directly to my pcp. Sometimes both occur.

What more does concierge do? Drive you there, lol

[Anonymous]

Anonymous wrote:When people here say their concierge doc "coordinates care," what does that actually mean? Serious question.

I have been in the traditional system, and if I need to go to a specialist, my pcp gives me a rec. for a provider/practice. I then go to said specialist and either tell my pcp how it went at my next appointment with her, or the specialist sends the results/lab work directly to my pcp. Sometimes both occur.

What more does concierge do? Drive you there, lol

Better specialist recs sometimes instead of just a referral to a deparment. Sometimes an in with specialists who aren't taking new pts.

[Anonymous]

I have various issues and thought going to an academic health center would be my best bet, figuring the doctors would all coordinate and talk to one another.

They simply do not.

I don’t know if One Medical is right for me, but it is disappointing that all the specialists operate in silos while babbling “holistic health care” and “whole patient blah blah”

[Anonymous]

Anonymous wrote:

Anonymous wrote:When people here say their concierge doc "coordinates care," what does that actually mean? Serious question.

I have been in the traditional system, and if I need to go to a specialist, my pcp gives me a rec. for a provider/practice. I then go to said specialist and either tell my pcp how it went at my next appointment with her, or the specialist sends the results/lab work directly to my pcp. Sometimes both occur.

What more does concierge do? Drive you there, lol

Better specialist recs sometimes instead of just a referral to a deparment. Sometimes an in with specialists who aren't taking new pts.

My mother, for example, has 8+ specialists and multiple chronic health conditions that impact other conditions and about 15 medications. Her concierge doctor manages all of that, as in, when a health issue arises, she is the first person I call bc she is trained better than I am to determine what is cardiology/nephrology/endocrinology/medication interaction etc. further, for ER visits, she calls ahead and gives full medical background and recommendations on what might be needed. She handles follow-up afterwards. She also gets specialists on the phone for consult much faster than we can as the patient and w/o our having to go in for unnecessary office visit. We get same day lab results. Calls back on weekends. Email/text answers within hours. I could go on but this is what managing care looks like.