Anonymous wrote:

Anonymous wrote:Yep. This is the wave of the future. My PCP and neurologist both charge concierge fees. And my neuro once recommended me to someone who didn’t take insurance at all!

I’m afraid care is going to become bifurcated between those who can afford extra fees and those who can’t.

As great as the ACA was, giving everyone who didn't have insurance access to primary care meant more patients than doctors could possibly handle. We had kaiser, but once enrollment swelled, seeing PCPs in a timely manner became impossible. We left for BCBS plus concierge and consider it the price of being able to see a doctor in a reasonable time frame

Only the laziest or least intelligent doctors are PCPs now (unless they are running a practice with underlings.)
PCP is a job for Nurse Practitioner or Physician Assistant now.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Yep. This is the wave of the future. My PCP and neurologist both charge concierge fees. And my neuro once recommended me to someone who didn’t take insurance at all!

I’m afraid care is going to become bifurcated between those who can afford extra fees and those who can’t.

As great as the ACA was, giving everyone who didn't have insurance access to primary care meant more patients than doctors could possibly handle. We had kaiser, but once enrollment swelled, seeing PCPs in a timely manner became impossible. We left for BCBS plus concierge and consider it the price of being able to see a doctor in a reasonable time frame

I don't find that I have that issue at all and to me telehealth has eliminated the need for PCP visits aside from well visits entirely. I can "see" someone within literally 30 seconds after pushing a button on my phone, have meds within the hour. For specialists the wait can be long but that was always the case for me.

So if you want to see a doctor with no ability to actually examine you, it's great?

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.

Medicare and the ACA are giveaways to insurance companies than primarily serve to bloat cost for everyone

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.

Our internal medicine PCP is retiring early (age 50?) and will likely be replaced in the practice by a NP or PA. We are not able to switch to another physician in the practice at this time because they are all over-booked. We haven't found a good internal medicine practice in our area taking new patients and we are reluctant to leave our well-run practice knowing we may not fare better elsewhere.

I wish our awesome PCP decided to go concierge instead of leaving medicine all together due to the long hours, high stress!

Anonymous wrote:

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

All of this 100 percent.

But if they can't manage to actually put your name in the email, not sure I'd trust them to manage this transition very well.

They pay companies to orchestrate the whole transition.

The trend is rampant in this area.

Participating doctors want to work less while earning the same or more. On one hand , who wouldn’t. On the other hand, they are turning their back on all but their richest patients.

This move does nothing to fix a profit-driven system. Rather, it gets on board.

Anonymous wrote:

Anonymous wrote:Yep. This is the wave of the future. My PCP and neurologist both charge concierge fees. And my neuro once recommended me to someone who didn’t take insurance at all!

I’m afraid care is going to become bifurcated between those who can afford extra fees and those who can’t.

As great as the ACA was, giving everyone who didn't have insurance access to primary care meant more patients than doctors could possibly handle. We had kaiser, but once enrollment swelled, seeing PCPs in a timely manner became impossible. We left for BCBS plus concierge and consider it the price of being able to see a doctor in a reasonable time frame

I don't find that I have that issue at all and to me telehealth has eliminated the need for PCP visits aside from well visits entirely. I can "see" someone within literally 30 seconds after pushing a button on my phone, have meds within the hour. For specialists the wait can be long but that was always the case for me.

Anonymous wrote:Yep. This is the wave of the future. My PCP and neurologist both charge concierge fees. And my neuro once recommended me to someone who didn’t take insurance at all!

I’m afraid care is going to become bifurcated between those who can afford extra fees and those who can’t.

As great as the ACA was, giving everyone who didn't have insurance access to primary care meant more patients than doctors could possibly handle. We had kaiser, but once enrollment swelled, seeing PCPs in a timely manner became impossible. We left for BCBS plus concierge and consider it the price of being able to see a doctor in a reasonable time frame

Anonymous wrote:My health insurance premium is going up 10% this year. If you look at Kaiser Foundation data they show average premiums are up over 20% in the last 5 years and almost 50% in the last 10 years to $25k per family.

If doctors aren’t getting that money then it’s the insurance companies’ fault, not the ACA (which actually requires that at least 80% of premiums be spent on care).

Also $25k (or more) isn’t “pixie dust”.

+1 our premiums are through the roof, and docs aren't seeing a penny of this, so opening conciergeries.

1. We will realize our insurance pays for nothing, stop purchasing it, except for catastrophic care.
2. Like the cable companies when everyone dumped cable and just got the minimum broadband connection, insurance companies will panic and start bundling their catastrophic care until it is just as expensive as our old premiums.
3. They profit and we are suckers again.
4. We need a single payer system and to stop enriching insurance execs.

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.

Or maybe the AMA and AAMC should be treated as cartels that they are and busted up? It’s absolutely insane we cap the number of physicians degreed per year when the entire country is facing an access crisis. Of course the docs don’t want to take a hit to their salaries though, so we have this insane system limiting the number of accredited schools and graduates every year. They also need to msssively increase the number of residency slots available every year.

This!!! With emphasis!!!

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Thank ACA.

This has nothing to do with the ACA.

Oh oh we have an expert here with first hand experience. Smh...all doctors will tell you ACA has made providing care harder, quality has come down etc etc. I know you're a dem but sometimes you just have to accept "facts"

Spoken like a true “always wrong but rarely in doubt” MAGAt.

Actually. I am a doctor and this is the sentiment. We have seen the changes first hand since ACA kicked in, you start to insure more and more with lower compensation = more people to treat for the same amount of money = quality of care goes down.

fun fact, the cost of these procedures has not increased for decades. For god sakes how can you PCP annual visit only be worth $50 for the provider??? How much is a meal for a family of 4? thats BS and you know it.

But you guys carry on as we go out of network.

What do you propose people do exactly?

Anonymous wrote:During the pandemic we moved out of DC to a place that doesn't have nearly as many good doctors. Also, due to COVID we wanted easy access to care outside of a hospital as possible.

It has worked for us. We go in 1x/year for full physical, then any other concerns have been handled over the phone, always on a weekend.

You pay extra for this? These days you can do Telehealth for between 0-30 from the phone as well.

Yep. This is the wave of the future. My PCP and neurologist both charge concierge fees. And my neuro once recommended me to someone who didn’t take insurance at all!

I’m afraid care is going to become bifurcated between those who can afford extra fees and those who can’t.

The Labcorp thread reminded me that my concierge PCP has an in-office phlebotomist.

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.

don't worry about stuff you will never ever see in your life...worry yourself about getting screwed by insurance companies and policy makers who keep squeezing med/dent and forcing them to see more and more pt at lower reimbursements sacrificing your care to buy votes with feel warm inside stories...LOL so naiive.