NaviNet Admin on December 6, 2012

Concierge Medicine: A Patient’s View

Is your DVR already programmed to record the USA Network’s Royal Pains big wedding special, “Off-Season Greetings,” on December 16 at 9:00 p.m. EST? We’re friends here. You wouldn’t be alone…This lavish Hamptons series began in 2009 against the backdrop of the real-life jump in the number of physicians practicing concierge, or retainer-based, medicine. Since beginning in Seattle in 1996, retainer-based physicians now conservatively number around 2,500, represented by organizations such as MDVIP, MD2, SignatureMD, and Specialdocs Consultants Inc.

The three main financial models of retainer-based medicine include the commonly known annual fee to be part of a clinician’s panel; the patient paying for all primary care services, and the doctors not typically billing insurance companies or Medicare for patient services; and a hybrid model, where a practice has a mix of retainer and third-party-paid patients.

While concierge medicine does have some controversial legal and regulatory aspects, we believe that it will continue to grow rapidly as patients seek what they perceive to be as “the best care”: care coordination, appointments that are long enough to really discuss their health and lives, and easy access to their physician. According to a Medicare Payment Advisory Commission report, several advantages for the physician include more time with patients, less stress and burnout, and more or comparable compensation.

Ilene Bezahler is the publisher of Edible Boston. This busy executive and advocate first learned about concierge medicine about five years ago after her internist told her during an appointment that she “only had time for one symptom.” Undiagnosed, Bezahler underwent more and more tests—and was prescribed a lot of drugs, an anathema to someone as dedicated to organic and natural principles as she is.

For $3,600 annually (nationwide, annual fees range $60-$15,000 according to a GAO study), Ilene joined the patient panel of a three-doctor concierge practice. The moment of truth came one night around 9:00 p.m. Ilene was having chest pains and was advised to go to the ER. Within an hour of being in the ER, her concierge physician was on the phone talking with ER staff and rang Ilene several times throughout the night to explain the tests she was undergoing. Even better, at 6:30 a.m. on a Sunday, Ilene’s doctor was in the ER checking on her.

On a routine basis, Ilene receives quick response to emails, immediate response to phone calls, and can get a same-day appointment. In addition, she feels that her concierge practice makes it easier and faster for her to get an appointment with a specialist.

When asked if she had a word of advice for different members of the healthcare continuum about concierge medicine, she replied:

  • For doctors: “Do this only if you want to go back to practicing medicine like a GP. The most successful part of this model is that you get to know your patients. It’s more than just the medicine. You need to be interested in the big picture—the patient’s life and environment—the whole package.”

  • For patients: “Be totally honest and open with your doctor.” (Probably good advice in general…)

  • For nurses and administrative healthcare professionals: “Make an effort to connect with the patients and develop a relationship with them. Do not just be the person who takes the vitals.”

What’s your opinion about concierge medicine? Continue the discussion by commenting on our blog, and connecting with us on Twitter, Facebook, and LinkedIn.

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