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

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[quote=Anonymous][quote=Anonymous]My friend is an internist whose practice transitioned to concierge over a 18 month period.  I'm sure they sent out a letter like the one in OP. As well, she would have a conversation with every patient at each appointment about the upcoming changes and invited MOST* of them to continue as her patient by paying $2000 annually.

Her business model was that she needed to sign up 150 patients in the concierge practice to be comfortable ($300k before liability ins. and overhead) and the optimal number in their model was 200 patients ($400k annual). Note that they DO get payment from insurance as well -- not sure where people are getting that "concierge" = "doesn't accept insurance."  Most do.

My friend used this transition as an opportunity to drop patients who were notably annoying.  Not notably sick -- she actually LIKES sick or complex people and sees them as a challenge to help and solve.  She wants to spend much more time with complex, appropriate demeanor patients and oversee and coordinate all their care.

OTOH, she was excited to kick out the bad personalities and get them off the rolls. Entitled, demanding DC people who typically tried to treat her as just another service person with no particular expertise. Kind of like the guy you hire to shovel snow.

She sees about 4-6 patients a day now and spends an hour or so at each appointment. She loves it. Writes really long notes, texts and takes calls into the evening IF WARRANTED. Works on Saturday and Sunday morning writing follow ups.  Rounds on people in hospitals if they're admitted.  She's very happy and makes a lot more money than when she had to see 20 people a day for 10 minute appointments and depend on insurance payouts exclusively.[/quote]

Exactly!! Our concierge docs seem very happy, much less stressed than when they were in regular practice (Same hospital system, just the really good docs get invited to join concierge) 
Mine has it even better---she shares the role with one other female doctor (both have kids in the ES/early MS age).  So you do you well visits with your doctor.  But if you need a same day appt, you might end up with the other (I'm fine with that, the sharing doctor is equally amazing).  Actually all of the doctors we have seen (between my spouse and our college kid and me) have been great. 
Who wouldn't be happier when you see 4-6 patients a day, get time to actually write notes and followup with patients.  Yes, you are on call for after hours calls/text from your patients.  But with only 200 patients, it is not that frequently.  Also, you are not on call every evening (10pm-8am) or weekends---that alternates with the other 4-6 doctors in the office.  So you get a weekend every 4-6 weeks and the week nights maybe one per week (I suspect they do a full week or several evening at a time you are on call, but dont know never needed to call then). 
 This is how medicine should be practiced---your doctor(s) should know you and your health history, not because you tell them it each time, but because they remember and/or read up on you before the appt (because they have 30 min between appts to finish up and prep for the next).

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