Concierge medicine. Is it what healthcare dreams are made of?

The physician house call revisits the modern world through boutique medicine.

Do you long for the old days? You know ’ the ones your father used to tell you about when mom gave him a chance to get a word in. Perhaps he reminisced about walking several miles to school, how hard his father worked to make ends meet, or the doctor that made house calls when anyone in the family fell ill. People say the days of physician house calls and the tender, personalized care that accompanied them are long gone.

All Things Work Together for Good

Out of America’s growing healthcare dysfunction emerges a new, healthier trend ’ Concierge Medicine. Also known as boutique medicine, this fast growing concept requires that patients pay an annual retainer, or fee, similar to those that attorneys charge clients. The annual feel ranges from $1,500 to $3,000 or more. Physicians with these exclusive private practices limit the number of patients they see, somewhere between 500 and 1,000, greatly reducing overall case load and allowing them to spend more personal time with patients. Those who advocate this healthcare model feel it benefits both the physician and patient by facilitating a more satisfying and thorough appointment experience for patients as well as proving quite lucrative for practitioners. If a physician limits his practice to 800 patients annually, the gross income from a $1,500 annual retainer paid by each adds up to $1,200,000.

What’s In It for the Average Patient?

In exchange for the annual fee, patients enjoy same-day appointments with no more long hours in waiting rooms full of others doing the same. Doctors actually know their patients by name and don’t flinch when ordering numerous preventive health screening tests. Patients have access to their personal physicians 24 hours a day, 7 days a week and aren’t burdened by calling a central line with recorded instructions ’ some concierge physicians actually gives them a direct number where they can reach him.

A carefully selected, well-trained medical staff works along with each patient and the doctor to ensure patients experience customized, personal healthcare at each visit. Concierge medicine breathes new life into the trusting doctor-patient relationship of yesteryear. Patient amenities include:

  • Physician house calls and emergency home visits
  • Very low physician/patient ratios (averaging one-fifth of the patient load per physician seen in most prevailing practice models)
  • Customized health care plans
  • Comprehensive preventive testing
  • On-site diagnostic tests
  • Staff scheduling of appointments with referred specialists
  • Treatment and diagnostic test scheduling
  • Curbside transportation service when necessary
  • Staff handles all correspondence with patient insurance plans, when available (many of these practices do not accept insurance), and advocates for the patient regarding approval of services, disputes, etc.

Free from the practice-choking burden of insurance policies, provider restrictions, and corrupt incentive programs, physicians can focus on actually providing appropriate and medically accurate care in the best interest of patients.

Enter the Concierge Controversy ’ Of Course

The ever-present hand of government that caused America’s current healthcare mess threatens to infect concierge medicine as well. The state of Maryland, where this new concept thrives, represents one of the many states considering regulation of boutique medical practices.

They argue that the concept more sharply demarcates the social classes regarding medical care than ever before. The indigent and profoundly poor cannot pay the $1,500 annual fee for services required for each family member seeing a concierge physician. Although very little official data exists regarding the proliferation of boutique medicine, Maryland officials estimate that each of these practices shut out 2,000 or more insured and uninsured patients that must seek new physicians with traditional practices to provide for their healthcare needs.

Considerations

Many concierge practices offer discounts on annual fees for children and spouses of paying members, making them more affordable than paying for insurance. An average annual fee of $1,800 works out to about $5 per day for the personalized, custom healthcare provided by these physicians. Many people spend that amount of money, or more, on over-priced, fancy coffees or tobacco products. Think about it. You can shut out the insurance companies and have your physician’s complete attention with 24/7 access to boot.

The author, Samantha Gluck, owns All Media Freelance, LLC where she works as a professional copywriter, blogger, ghost writer, and contributing author for several online publications.

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Samantha Gluck All Media Freelance, LLC

Samantha Gluck owns All Media Freelance, LLC where she works as a freelance health care journalist. Launched in 2011, the business has grown rapidly, requiring she add four staff writers to the AMF team. Gluck's work is featured in numerous prestigious publications, including the Houston Chronicle and the newly launched Balanced Living Magazine.

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As a concierge pediatrician and the president of the American Academy of Concierge Pediatricians, I agree with most of the points of this article, particularly the affordability of concierge medicine. I would also like to point out that there has never been a public outrage against private school with costs as high as 30k for kindergarden tuition. People pay their taxes and have the option to opt for “better” education. The only point I disagree with is that concierge medicine “shuts out” the insurance company. My patients pay up front for their care, and then submit to their insurance company. Expensive lab tests and hospital charges are billed directly to the insurance. People need insurance for big things like hospitalizations, but not for affordable things like primary care.

Comment by Edward Kulich MD — April 3, 2011 @ 8:16 am

Dr. Kulich,
Thank you for taking the time to read my article and comment on it. Since you are a concierge pediatrician, your opinion and personal experience lends authority to this concept that is new to many. I agree with you that people need to continue to carry insurance for more expensive healthcare needs. Perhaps I should have clarified that in the piece. Do you think people, who wish to see a concierge PCP, could get away with purchasing hospitalization insurance or some variation of insurance that does not include coverage for primary care? I plan to interview some physicians with concierge medical practices here in the Houston area. Once I do this, I’ll write it up and post it here. Please feel free to add your experiences and thoughts to the ones I receive from the physicians I interview.

Comment by Samantha Gluck — April 3, 2011 @ 9:32 am

I agree that people that want to use a concierge MD can get insurance to cover for more expensive and catastrophic expenses. It really is their choice. The bottom line is that in the US, healthcare is a commodity and a product. It is a highly regulated and important product, but a product nonetheless. Until healthcare is treated as a right and not a commodity by our government, our healthcare system will continue to fail us.
My fees for my patients come down to less than what one would pay for smoking a pack a day. It comes down to choices. If you value your health, then prioritize it.

Comment by Edward Kulich MD — April 11, 2011 @ 11:08 pm

Well said, Dr. Kulich. People not only must prioritize their healthcare, but I believe they must also develop personal responsibility for their health and healthcare. They must take charge of their needs and health goals and discuss these with their physicians.

Comment by Samantha Gluck — April 12, 2011 @ 8:09 am

Thank you Ms Gluck and Dr. Kulich for your article and your input. I am a student in Healthcare Administration. I am currently taking a class in healthcare law. We must do a research paper and a presentation on an legal and/or ethical issue within healthcare. My group and I choose concierge medicine. I enjoyed your article and input. If you have any suggestions for me I would welcome them.

Comment by Jennifer Frasier — January 27, 2012 @ 7:15 pm

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