The last time you called your doctor’s office, how long did you have to wait for an answer? How long do you normally have to wait for an appointment or wait for a prescription to be called? When you arrive at the office, how much time do you spend in the waiting room and how much time does the doctor spend with you?
Did you get all the answers to your questions? How many seconds do you have at the beginning of your appointment to explain your symptoms before they interrupt you? Do nurses and doctors seem more interested in your computers or graphics than you?
If your experiences are like most people’s, your answers to these questions are not very flattering for the medical profession and for the healthcare system in general. Most doctors really don’t want their practices to be like this, but they don’t have many options. They must have a large volume of patients to be able to make ends meet financially. The high volume makes the clinic a very busy place, and most patients feel that they do not receive much attention.
In 1996 in Seattle, a doctor named Howard Moran thought there should be a better way to do this. He pioneered the concept of having a lower volume practice with highly attentive healthcare provided as a service to patients in exchange for an up-front fee, just like many attorneys or accountants use. This fee may be in addition to or in lieu of the regular office fees that are billed to insurance companies. This concept allows the practice to remain financially sound while providing better and more attentive medical service to its low patient volume (typically keeping the patient countdown to approximately one-tenth the number in a traditional practice of typical primary care).
Unfortunately, health insurance companies currently do not pay for this type of service, so patients have to pay for it out of pocket, but if the service is good, it may be worth it. Patients who join these practices are encouraged to maintain their regular insurance that they will need for visits to other specialists, laboratory tests, radiological tests, and / or hospital services if necessary.
Many concierge practices offer same-day or next-day appointments, no long waits for appointments or prescription refills, direct access to your personal doctor day or night, home visits if needed, ongoing care if you are hospitalized, comprehensive physical exams, audiometry tests, cardiovascular and cancer risk detection, increased attention to preventive care, leisurely appointments, answers to all questions, family meetings if necessary, coordination of care with specialists, provision of health records personal data on CDs or USB sticks, etc., etc.
Depending on the type and amount of services being provided, the fixed retention fee can vary widely from one area to the next, ranging from $ 100 to $ 20,000 / year, probably averaging around $ 1500-3000 / year . There were only a few hundred of these doctors a few years ago, but now there are more than 5,000 across the country. Many, but not all, of them are listed on the main website of the American Academy of Private Physicians: http://www.aapp.org/. Patients can find a Concierge Physician in their area on this site.
There has been some controversy surrounding some of these practices because some authorities feel that the growth of concierge medicine will lead to a 2-tier medical system in this country: one for the rich and one for the not-so-rich. In addition, with the current shortage of primary care physicians (PCPs), with an increasing number of concierge practices, the number of PCPs available for traditional offices will be even less and access to care for patients served by those practices will be affected. On the other hand, more medical students may become interested in primary care if they have opportunities in concierge medicine when they finish their residencies.
Some of these practices have been criticized by insurance companies who say that janitorial doctors basically provide an insurance plan for their patients without having an insurance license to do so. Therefore, practices must be legally and financially structured in such a way as to avoid these criticisms.
In general, the concept of concierge medicine offers a good alternative to the currently unsatisfactory traditional model of medical practice. The fee may seem high to some, but in most cases, it is probably not much higher than the cost of the local cable or phone bill, or the same as what a family would spend eating at a restaurant once a week. week.