Some time ago my original PCP, whom I loved, went concierge with plans to retire within five years. Not wanting to put off finding someone new I figured it would not be that difficult to find someone with a comparable reputation in the area who had not yet gone this route. Wrong. We ended up making the switch to another doctor, also concierge, but this time affiliated with hospitals we prefer.
In truth, I’m not happy to participate in a system that provides tiered access but cannot argue with the advantages and quality of care. The well known providers in this area have all gone this route, unfortunately.
@roshke Yep, many of the best doctors in our area have gone that way also. There are very few general practitioners around who are excellent and not concierge. There are lots of wealthy people in the area ( who are busy and may have long term health issues so they will pay).
I think this might be the wave of the future as long as billing and admin consume more time and there are limited numbers of doctors relative to an aging population.
I wonder how long it will be before concierge comes to more rural areas. The worst thing about dr appts are trying to cram a ton of things into 15 minutes and knowing you’re just a number who gets a quick glance at a chart prior to an appt rather than a person with individual traits, etc. If you don’t match up to “typical” you’re just plain out of luck, but make sure you pay the bill ASAP.
I can definitely see why anyone dedicated to really being a doctor who cares about their clients vs a cog in the system opts to head this route.
I wonder if it’s worth it to travel to a city for health care. We already travel for airports, certain forms of entertainment, and some dining, etc. I absolutely love living rural and have no plans to change, but I’m now pondering if my frame of mind about health care should change. We have Urgent Care clinics here if any sort of true emergency (that couldn’t wait an hour or two) came up.
During our upcoming heat wave when we’re tucked inside hiding from the outdoor oven I might have to expand my search to see who’s around within an hour or two.
About 15 years ago, my favorite doctor went concierge. The way it was presented at the time was $5K per year and some discounted larger amount for me and spouse. The 5K included unlimited appointments per year, same day service always if requested, no extra copays or any other fees other than lab work. It seemed to me that it made zero sense for anyone who was in general good health. But I guess people with chronic illnesses who are seen frequently and need or enjoy long appointments with lots of discussions would love this kind of service.
Even 15 years later, this would not be cost efficient for us with our current health status. But I can see the allure for someone who is sick a lot or has conditions that need frequent monitoring.
@Nrdsb4 I definitely agree that this seems to be more of a timing deal. When one is young and healthy (assuming one is young and healthy), there’s no need. I know we went years without ever having to see a doctor in our early adulthood (pregnancy excepted, of course). As one reaches middle age (or for some, sooner/later) and health issues hit, then it becomes far more attractive to have someone who knows “you” vs not - even if one goes for a bit between appts.
This isn’t a one size fits all situation. It’s even good that the “better” doctors are in this sort of system as they’ll be seeing the folks who are likely to need more expertise than “typical.”
I just checked—in my state, there are only 8 concierge MDs. I’m glad that’s a fairly small amount so it isn’t such a burden on the other practicing MDs.
I really like my new internist. Even though I do have a chronic condition, it’s currently quite stable and under good control. I do appreciate knowing I can and do have 1 hour visits with my lung specialists when I fly to see them. M
$4-5k/person/year plus copays plus deductibles is a LOT of money for just one MD. I honestly don’t think for my and H’s current health that we could justify such annual up-front costs. Yikes! We pay less than that to fly to my mainland docs 2x/year.
IF we had conditions that needed frequent same day appts, possibly we could consider it but I’m so glad we aren’t being asked to make that choice yet.
In the scenario I described, the 5K required no copays and no deductibles. It’s an all you can eat MD smorgasbord for one price. However, if you have to go outside of the office for procedures, lab work, hospitalization, etc., of course deductibles and copays apply.
Then, as of now, it makes no financial sense at all for DH andmeI to sign up with such a plan. Hopefully never, in fact.
Yes, but chances of me being able to get all my care from ONE MD are pretty remote. I do need the medical insurance and Rx and specialists like lung doc, ob/Gyn, etc. I can see it for folks who see and need MDs more than the rest of us who see them once or twice/year for 15 minutes. For now, I’m good with what I have.
Almost all of my specialists are in the Univ of Michigan medical system. They’re launching a new concierge program costing $2,700 a year (for individuals) to have more access to your specialists.
I can afford it but I refuse to pay for it even though I have very complicated health conditions. There’s already far too much inequality in our medical system and I refuse to contribute to it further.
Wow, have never heard of a larger medical system having a concierge program, only individual MDs via MDVIP. It’s scary if they all end up going concierge. as you say, increasing inequality.
Or perhaps it will just be another thing for the $250,000+ income people to complain about (besides college, taxes, housing, etc.) when they feel that they cannot make their personal household budgets balance.
A friend did this when she relocated and found that it was a great way of getting excellent referrals with docs who would see her. If you are not connected to the medical establishment where you live, it can be very helpful to have someone acting as advance guard. If you have had run-in with less than great docs/medical care, the value will be apparent.
Here’s a few thoughts, from someone personally affected by all this. My wife closed her clinic 18 months ago.
With the cost of med school, one would have to be a saint or an idiot to choose primary care. It pays 1/3 what a specialist gets around here but requires more hours than many specialties. My wife suggests dermatology (set hours, some cash business like Botox, no phone calls after hours) to people with big loans who want a life.
A clinic cannot stay in business on a Medicare reimbursement rate, to say nothing of the Medicaid rate. This puts a damper on the whole “Medicare for All” movement. You cannot repay loans practicing in a poor area where many do not have good insurance. It’s not enough without retooling the whole system.
Concierge medicine is a symptom of some of the ills of our healthcare delivery system. A Dr. can get the same amount of money for half the work if he sees only rich people. That leaves the remaining providers with higher proportions of poor clients and pushes them toward shorter appointments and less service.
Some of my wife’s patients drive more than 100 miles to see her. Primary care in small towns can be backed up 6 months or more. This goes for pediatricians as well.
Some hospital-run clinics have concierge-level care and run at a loss in order to capture business for specialists. That is also the Kaiser model.
I’m with Romani on this one. I refuse to participate in it, but it is a lot easier for me.
Or have wealthy parents funding much or all of your medical school, or be a NM or TX resident going to an in-state medical school, or grow up in another country where medical school is more heavily subsidized and lower cost to the student and attend there before getting to a US residency…
It’s disheartening to see the attitude towards primary care practice (not from posters here, just in medicine in general). In theory, PCP are on the front lines and have the best chance to prevent things down the road. Why so many disincentives to practicing PCP?
As to the concierge, I just found out I need a crown on a tooth, so that is almost the same cost as the annual MDVIP charge - I just can’t justify it. It seems like a big luxury for me, considering I have no active chronic conditions. I should be able to provide the same care from a regular internist (assuming I can find one) and my own methodical research plus Dr. Google and my friends who are MDs. That is truly a first-world problem and solution, I am acutely aware.
In theory, we need the best physicians in primary care. A patient can come in with anything, and the primary care physician needs to know enough to point the patient and the medical care system in the right direction – going the wrong direction can be both harmful to the patient and expensive, in addition to failing to solve or explain whatever medical problem the patient has.
But pay levels suggest that this is not valued in the US medical care system.
Yes, it really would be good if primary care was better compensated in the US. Having a good primary care doctor really does help a great deal in helping manage care, especially as we age and/or gave more complex health issues.
Which is why concierge medicine has started in the first place, no? To make the pay more correctly reflect the job (and allow more time to do the job well)…
Few folks who can do a job really well (any profession) want to get paid diddly to do it while working their tails off and being bogged down in paperwork - in the case of a doctor, esp if they also paid for med school, etc. Undoubtedly there are some, but it’s not exactly typical human nature to want to do that when there are other options.
But does concierge medicine get you a better physician, or just a more “luxury class” experience with one, for the higher cost? Seems like the self selection process of choosing specialties is baked in by the time physicians are practicing and deciding whether to go concierge.