Concierge Medicine

[Anonymous]

I’m part of a concierge practice. I think the real benefit is that she doesn’t have a huge number of patients, so she is very in tune with my health and knows me well. My appointments start on time and last as long as it takes for me to discuss everything I want to discuss. It’s also nice to be able to reach her at any time - evenings, weekends, holidays, she’s always available. We started using her practice during Covid because my husband got scraped up in a biking accident and the ERs and clinics were all completely overwhelmed with insane wait times. A friend recommended her, and she was able to get us admitted as a new patient and send a doctor to our house to sew him up and give us antibiotics (so we didn’t have to deal with the pharmacy) within a few hours. She does charge a pretty high annual fee and she doesn’t take insurance, but I think it’s worth it.

[Anonymous]

Anonymous wrote:I’m part of a concierge practice. I think the real benefit is that she doesn’t have a huge number of patients, so she is very in tune with my health and knows me well. My appointments start on time and last as long as it takes for me to discuss everything I want to discuss. It’s also nice to be able to reach her at any time - evenings, weekends, holidays, she’s always available. We started using her practice during Covid because my husband got scraped up in a biking accident and the ERs and clinics were all completely overwhelmed with insane wait times. A friend recommended her, and she was able to get us admitted as a new patient and send a doctor to our house to sew him up and give us antibiotics (so we didn’t have to deal with the pharmacy) within a few hours. She does charge a pretty high annual fee and she doesn’t take insurance, but I think it’s worth it.

There are plenty that DO take insurance. Your added CM fee (of $100-300/month) is what allows them to take all the time you need at each appt. It allows them to have 1/10 to 1/4 of the patients they previously had to have to make ends meet.

[Anonymous]

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.

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?

My One Medical PCP is not taking on new patients. I was a previous patient so I got in. It took months to get my first appointment. However, when I had a semi urgent need, I was able to get in to see him on Monday after calling their 24/7 line on a Saturday. Most likely I will not see him for urgent visits and I'm Ok with that. I chose this knowing he would be too busy at times. I'll see a PA for colds which is think is just fine. My goal was to have a smart dr who could focus on my health in general 2-3 times a year. I can always email him too for a quick response.

The Chevy Chase office is getting new doctors in a few months. My mom saw Meggie and thought she was great.

[Anonymous]

I recently joined One Medical after my long time PCP went concierge for an $1800 per year fee. With no ongoing health issues, it was hard to justify. I am loving One Medical and their affiliation. With MedStar for referrals to specialists. I can do everything from the app including viewing lab results, scheduling appointments, making changes to existing appts, having digital access to a referral. I haven’t had to pick up the phone to call anyone. I recently had a mammogram at Wash Radiology and the results came to me in a few days via the One Medical app vs the paper results that Wash Radiology mails a week later. It’s been amazing. If you switch docs within the one med network anyone has access to your records. Super efficient and docs are also avail via te t/email and virtual visits. If you wake up in middle of night with an I’ll ess u can do an urgent visit immediately online via the app.

[Anonymous]

Can you recommend your hospital system or the place where you get concierge medicine?

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.

Would not pay if my CM doc did not do those things. As stated, we are part of a "hospital system", so they organize everything (within the system). Our CM docs will even go with you to a specialist appt if you have a very serious condition and want them to (I've never needed it but they would if needed or would zoom in for the appt). So it depends upon the plan. For ours we get a lot of benefits.

[Anonymous]

Who is she getting CM from if you don't mind sharing?

Anonymous wrote:

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.

[Anonymous]

Anonymous wrote:I get concierge service by simply being tenacious and persistent. If I need help, I document it by sending a note through their portal. You have to find a way to bypass gatekeepers for sure. Squeaky wheel!

You might be getting the end result you want, but having to be a tenacious, persistent squeaky wheel to get it means you are getting the opposite of concierge service.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I get concierge service by simply being tenacious and persistent. If I need help, I document it by sending a note through their portal. You have to find a way to bypass gatekeepers for sure. Squeaky wheel!

You might be getting the end result you want, but having to be a tenacious, persistent squeaky wheel to get it means you are getting the opposite of concierge service.

+1000

In CM I have my doctor's Cell Phone #. I can text/call at any time and they will respond or the doc on call that night/weekend will respond. I don't have to be a squeaky wheel---it just happens automatically with no wasted time/effort on my part

[Anonymous]

Sounds to me like this is where we are heading:

wealthy people get more healthcare than they even need (your doctor's cell phone #, so you can call they day or night??)

and the rest of the population won't get the care they deserve (i.e. a timely appointment and responsive provider, when that is indicated).

And many on DCUM have no problem with that.

(Too bad we no longer share a sense of community)

[Anonymous]

Where we're headed is the industrialization of outpatient medicine: cheaper NPs and PAs in larger practices doing the majority of care with limited continuity and either physicians overseeing the midlevels while trying to maintain whatever continuity they have or going out of the system into smaller concierge practices. Psychiatry has already moved to not accepting insurance and people sort of just accept that that is how it is. Insurance does not reimburse non-procedure based specialties so there is not much incentive to play the insurance game.

[Anonymous]

Anonymous wrote:Where we're headed is the industrialization of outpatient medicine: cheaper NPs and PAs in larger practices doing the majority of care with limited continuity and either physicians overseeing the midlevels while trying to maintain whatever continuity they have or going out of the system into smaller concierge practices. Psychiatry has already moved to not accepting insurance and people sort of just accept that that is how it is. Insurance does not reimburse non-procedure based specialties so there is not much incentive to play the insurance game.

Not much incentive for doctors.

Most patients have not choice.

[Anonymous]

Anonymous wrote:Sounds to me like this is where we are heading:

wealthy people get more healthcare than they even need (your doctor's cell phone #, so you can call they day or night??)

and the rest of the population won't get the care they deserve (i.e. a timely appointment and responsive provider, when that is indicated).

And many on DCUM have no problem with that.

(Too bad we no longer share a sense of community)

I pay for Concierge Medicine. I support universal health care and think we should have had it for decades now. One can do/support both.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Sounds to me like this is where we are heading:

wealthy people get more healthcare than they even need (your doctor's cell phone #, so you can call they day or night??)

and the rest of the population won't get the care they deserve (i.e. a timely appointment and responsive provider, when that is indicated).

And many on DCUM have no problem with that.

(Too bad we no longer share a sense of community)

I pay for Concierge Medicine. I support universal health care and think we should have had it for decades now. One can do/support both.

+1

Exactly! I'm wealthy and I vote for the team that supports Universal Healthcare and costs me more in taxes. However, I'm not going to not pay $3-4K/year for my family to have CM simply because "everyone does not have access". Yes I recognize it's a privilege. I know "non wealthy " people who pay for CM as well--they consider it important and budget for it.