Drs office charging monthly fee for "better service"??

[Anonymous]

Anonymous wrote:

Anonymous wrote:Let me guess. They are going "concierge." Our internist did this and we found a new doctor. It disgusted me, because we were told the $ was for "access" to the doctor, and not medical services.

This will probably be illegal in a few years. It should be.

are we entering a socialist state?

are you an idiot?

[Anonymous]

But arent doctors who set up shop in an office on foxhall vs in south arlington doing the same thing, Excluding certain parts of the population? What about those affiliated with Sibley vs GW or another metro accessible hospital? Those who advertise in Washingtonian vs the City Paper--arent they also targeting certain patients? Or doctors who charge $150 for a visit vs $50? Or who accept aetna vs bcbs vs no insurance?

Just because medicine helps people doesn't mean that it isn't a business. And I mean that literally, doctors offices are actual businesses. Not nonprofits. Why wouldn't a business person want to make as much as they can? That doesn't mean they still aren't helping people.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I have a doctor who takes virtually no insurance, which means I pay out of pocket, submit my receipts, and get whatever percentage my insurance offers for out-of-network. But all that is worth it because when I have an appointment at 10:00, I get seen at 10:00.

I get this concept but it's different from paying $45 monthly fee for better service at your doctors office.

I can tell you from personal experience that although the concepts are different, they can be linked. I posted earlier about paying 45/month for privia for my internist and how much I like him. I later posted that my gyno (reiter hill) won't spend more than a minute with me. What it didnt occur to me to mention was that my internist charges the $45/month and does not take any sort of insurance I've ever heard of. Like the above poster, I pay out of pocket and get reimbursed whatever my insurance co pay for out of network. It's still worth it for me, but I will say that when I have a minor cough that might otherwise send me to the dr I am more inclined to just call or see if it will go away than to go and see him for 250 out of pocket.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Better care to me means a dr spending the time with you to listen and to figure out what is actually wrong. Better care is the opposite of what i get at my gyno, reiter hill, where i wait for an hour to spend 1.5 mins with the dr. It's awful. I pay privia so my internist doesnt become my gyno. So he doesnt have to take on a ton of patients and see them all for 5 mins to make money, which seems to be what my gyno has decided to do.

Go midwife!

My (non-profit) OB has responded to increased financial pressure by shortening appointments to nothing to squeeze in as many paying patients as possible. I pay out of pocket for my midwife, who comes to my house for appointments and stays for an hour or more. There are GYN midwives out there, too, and I think it is worth every penny.

It is also true that primary care doctors, who have always made the least, now make even less. My MIL is a pediatrician, and her income has steadily decreased over the years, even as her patient load increased. She dropped Tricare in a military town, even though she came to America by joining the US military, because their reimbursement rates dropped below Medicaid. She is well past retirement age, still working 100+ hours a week, both because she loves her work and because the value of her practice has dropped so much. No more "selling practices" to retire...

I'm the PP w/reiter hill (cannot STAND them). What exactly does a midwife do? What kind of education is required of them? Can they prescribe medication? My first reaction to your post was "you have GOT to be kidding, a midwife??" but honestly I don't know anything about them and never even considered that as an option. (Sorry just being honest) Please educate me and others who also may have no clue about what they have to offer. Thanks.

[Anonymous]

Anonymous wrote:I would pay $100 a year to be able to email a doctor and get an answer back within a day. That would be very cool.

You should look into One Medical Group-- they just recently expanded to DC and this is one of their selling points (along with same day appts)-- I think the annual fee is $199 but they take most insurance.

http://www.onemedical.com/dc/doctors

http://www.nytimes.com/2011/02/01/health/01medical.html?pagewanted=all

I'm a way out there lefty that thinks we ought to have public (free) med schools and single payer health care, and I dropped two different internists who went concierge (the first wanted $2k a year and the second $1500 I think) and relied on minute clinic/urgent care centers for the last 5 or 6 years, but I don't really get the level of moral outrage about this. It's pretty obvious that people with more money will get more health care (just like they get more food, bigger houses, etc.)- the only question is whether or not we will provide a minimum level of healthcare for everyone, and how much power/revenues the insurance cos. will have. Part of the healthcare reform bill is a requirement that insurance companies spend at least 80% of their income on actually reimbursing doctors. I think that's great, but it kind of boggles my mind that even after healthcare reform 20% of health insurance premiums just go to paperwork/profit for the insurance company.

[Anonymous]

Not Obamacare. Not lawyers.

Insurance companies, my friend. Have a few doc family members of our parents' generation. They're doing something more drastic than concierge service: they're no longer accepting insurance. Flat fee, my friends. They no longer want to deal with the piddly amounts the insurance companies pay them (can't even cover overhead costs) and the waits... the waits... the waits for the checks.

I remember seeing something like a $15 check from an insurance co for an hour-long office visit. $15. That doesn't cover the rent, the secretary, the malpractice insurance, much less the salary of that hour of the doc's time. Holy hell.

[Anonymous]

Anonymous wrote: That's your right. But if you have one of these practices, I do look at you a little differently: your motives are not about helping all those in need. Your motives are about helping those in need who can afford to pay.

Exactly
We soon will have poor insured people who cannot afford to go to the doctor and will instead wait until they are even more sick that they have to be admitted to a hospital
And do not say that by choosing a certain location doctors are excluding a certain part of the population. What happens when there is only 2 doctors offices withing a bus-stop distance from where you live and to find a doctors office without add on fees is too far

[Anonymous]

I am sorry some of you have to deal with this issue. It seems very wrong. I love my doctors who take my insurance, see me the same day if needed, take all the time needed to help with the problem, and call or email me personally. Doesn't cost extra, they are just wonderful people.

[Anonymous]

Anonymous wrote:I am sorry some of you have to deal with this issue. It seems very wrong. I love my doctors who take my insurance, see me the same day if needed, take all the time needed to help with the problem, and call or email me personally. Doesn't cost extra, they are just wonderful people.

You realize some of these great doctors no longer take insurance for new patients or are no longer taking new patients at all. I get this level of service but pay out-of-pocket and wait for whatever is the reimbursement for out-of-network. I don't mind and worth it to me.

[Anonymous]

what happens when the insurance is not able to provide pcp's for insured people because every doctor on their books is charging extra fees?

[Anonymous]

The last straw for DH was when they installed the self-checkin kiosks at GW for his internist. Like a freak'n airport. Have to make an appointment for an annual physical at least 3 months in advance, waiting area is a zoo, PITA. We'll pay extra for better service.

[Anonymous]

Anonymous wrote:[

Hogwash. It has to do with the insurance companies. Our doc instituted a similar fee structure this year. They simply could not sustain the practice at the rates the insurance companies were paying them. The insurance companies, on the other hand, are pressed by increasing technology/medical costs and the fact that there are not enough healthy people in the insured pool. (Plus, they need to pay their executives bonuses and salaries that would make Imelda Marcos blush!)

I haven't made up my mind on Obamacare, and malpractice is no small issue, but these fees are coming from someplace considerably more complicated than the pp's politically motivated pablum makes clear.

100% agree with this. I had several doctors completely drop insurance during the prior administration, this is NOT an ObamaCare issue. The insurance companies are squeezing the PCP's way too much. On the one hand, I don't blame doctors for using the Privia service to try and make ends meet, run an efficient office and be able to pay their staff competitively, and also provide better service. However, for me, the whole notion of providing those with the most money the best care is so disturbing. Those extra conversations will save the lives of affluent people, and all of those who are 'merely insured' will suffer. '

Agree 100%. This makes me very uncomfortable.

[Anonymous]

Anonymous[b wrote:]^ Yeah, the difference is if you get a bad haircut, no big deal. You get a bad doctor, diagnosis, or treatment, the stakes change.

Sad state of affairs when we compare healthcare to entertainment.

[/b]


Thank you. You can definately tell who the privileged are on this forum. Just thank your lucky stars you have extra to pay for "better care."
I will just pray that we remain healthy because we will not be able to afford a monthly fee just to make sure we get extra time, extra patience,extra kindness, a complete and torough exam and correct diagnosis at the doctos office.

[Anonymous]

Anonymous wrote:I am sorry some of you have to deal with this issue. It seems very wrong. I love my doctors who take my insurance, see me the same day if needed, take all the time needed to help with the problem, and call or email me personally. Doesn't cost extra, they are just wonderful people.

My GP practice is just like this as well.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Better care to me means a dr spending the time with you to listen and to figure out what is actually wrong. Better care is the opposite of what i get at my gyno, reiter hill, where i wait for an hour to spend 1.5 mins with the dr. It's awful. I pay privia so my internist doesnt become my gyno. So he doesnt have to take on a ton of patients and see them all for 5 mins to make money, which seems to be what my gyno has decided to do.

Go midwife!

My (non-profit) OB has responded to increased financial pressure by shortening appointments to nothing to squeeze in as many paying patients as possible. I pay out of pocket for my midwife, who comes to my house for appointments and stays for an hour or more. There are GYN midwives out there, too, and I think it is worth every penny.

It is also true that primary care doctors, who have always made the least, now make even less. My MIL is a pediatrician, and her income has steadily decreased over the years, even as her patient load increased. She dropped Tricare in a military town, even though she came to America by joining the US military, because their reimbursement rates dropped below Medicaid. She is well past retirement age, still working 100+ hours a week, both because she loves her work and because the value of her practice has dropped so much. No more "selling practices" to retire...

I'm the PP w/reiter hill (cannot STAND them). What exactly does a midwife do? What kind of education is required of them? Can they prescribe medication? My first reaction to your post was "you have GOT to be kidding, a midwife??" but honestly I don't know anything about them and never even considered that as an option. (Sorry just being honest) Please educate me and others who also may have no clue about what they have to offer. Thanks.

Here is one midwife group that offers gyn services:

http://www.birthcare.org/

You can read their profiles if you want to know their educational backgrounds. Yes, they can prescribe medication. This group does not usually do in-home appointments, but there are midwives who do.