At the first part of January, my husband and I received separate envelopes from our doctor, one addressed to each of us. Inside was a fancy-shmancy brochure about the new practice he was going to be starting. He was “announcing exciting changes” and told us that his practice would be “personalized.” It would also have “limited enrollment.” He said these changes would be taking place in March and we could call him right now to find out more or we could stay tuned for further details.
We didn’t think much of it. Is he moving? If so, we’ll find a new doctor. It’s inconvenient and annoying to look for a new doctor, but not as annoying and inconvenient as it would be to change locations.
Just this last Saturday, we each got another envelope from our doctor. This one was thicker, containing several pieces of paper. This must be the explanation about the new exciting changes!
The letter was lengthy and started out by saying that he’s establishing a “concierge medical practice.” He will be offering “highly personalized medical care, exceptional service, and a strong focus on prevention and wellness.”
Okay, great! But, don’t we already get personalize care? The service is what it is, and I’ve never had any complaints. Prevention and wellness have always been a priority.
I’m confused. What’s changing?
He goes on to say something about how he’s been practicing internal medicine for over 10 years, and something about current time constraints and how he will now be unhurried and we won’t have to wait to see him.
The letter is 7 paragraphs long and goes on and on. It mentions that he has included a detailed description of his new practice along with a FAQ (Frequently Asked Questions) Page. I skim the rest of the letter, still somewhat confused as to how this is all going to affect me, and then I turn to the accompanying material.
Maybe he’s moving offices? Well, if he is, we’re finding another doctor. I love having all our doctors at the same medical park, the same location as our hospital.
Nope, his address is the same. It’s one of the questions on the FAQ.
Again, I’m confused. So, what’s changing?
Then, I get to the Patient Agreement Form.
Let me summarize this lengthy and very-legal-looking paper. Seriously! It’s longer than a standard 8 ½ by 11 sheet of paper:
In order to remain with our doctor, we need to pay a Patient Membership Fee. Wanna know what kind of money we’re talking about? Check this out:
- Individuals 45-yrs and older** = $1,850/year
- Adult Couple 45-yrs and older** = $3,400/year
- Individuals 44-years and younger ** = $1,450/year
- Adult Couple 44-years and younger** = $2,600/year
- Unmarried dependent child of member 16 to 25-yrs** = $300/year
**(age as of March 1, 2009)
WHAT!?
And, it’s NOT COVERED BY OUR INSURANCE.
EXCUSE ME!?
So, let me get this straight. My husband and I will need to fork over $2,600 a year in order to be seen by our doctor. Oh, if that amount is inconvenient in one large chunk, you can pay half of that now and another half in September.
This cost is in addition to what we pay for our insurance. Now, for the record, we have excellent insurance. My husband’s employer pays oodles-of-thousands of dollars to insure us. We pay a fraction of that cost, but our portion still equals thousands of dollars a year. It all comes out of the paycheck, so we don’t have to come up with that money on the fly, but it’s not free healthcare.
And, I dare argue, that there is no such thing as free healthcare. It costs someone somewhere something…but I digress.
That being said, we get what we pay for; we would be in a precarious position without our coverage. We have excellent insurance, and I’m so thankful for it.
So, what is our doctor going to be giving us for our $2,600 a year?
Let’s take a look at his handy-dandy little list:
- Comprehensive annual medical exam
- Same day or next day appointments
- Little or no office waiting times
- Longer appointments when needed
- Preventative Care
- Direct phone access to me or my nurse during office hours
- His personal cell phone number
- House calls and selected nursing visits (may be offered)
- Home Rx delivery (TBD on a case-by-case basis)
- Coverage for when he isn’t available
- Hospital care (he’ll work closely with the physician on call at the hospital)
- Your annual exam results will be made accessible to you
- Convenient email access for non-urgent health issues or questions
- Focus Group Meetings about health issues.
- Counseling with patients and families about living wills and powers of attorney
Wow. That list looks rather extensive! But, let’s break it down:
- Our insurance already covers the cost of an annual exam, and it had better be comprehensive.
- We have no problem getting in to see a doctor if we have an emergency.
- We haven’t had to wait incredibly long in the doctor’s office, but guess what? We expect to! It’s a doctor’s office!
- I’ve never been rushed out the door because my 15 minutes to talk to the doctor was up. (In fact, if we’ve had to wait in the waiting room, it’s because appointments ahead of us are taking longer than scheduled. What goes around, comes around.)
- I’ve always been able to leave a message for him and his nurse during office hours…IT’S DURING OFFICE HOURS.
- If he’s been out of the office, it’s never been an issue to see another doctor or a nurse practitioner in the office.
- In the event that we’d need hospitalization, he would be kept in the loop. They just put all their medical records into an electronic format to help facilitate that!
- I’ve always gotten the results to my annual exams.
- Both our insurance company and the hospital we use provide email and phone support for non-urgent health issues or questions.
- The part about focus groups was extremely vague, but it looks nice on his little list, and the last time I checked, it was best to get legal advice from a lawyer, not a doctor. (Plus, we already have our living wills and powers of attorney all set.)
So, by my calculations, we’d be spending $2,600 a year to have his personal cell phone number, have the possibility of a house-call and maybe someone would bring us our prescriptions.
I’m appalled.
I’m flabbergasted.
I’m done with this doctor.
I’m extremely bothered by this, and I can only imagine how I’d feel if I really had a great personal relationship with this doctor. I mean, we have been seeing him for over five years, but we’re healthy. We haven’t been in to see him a lot, but he was someone we trusted when we did need to use his expertise. We ended up with him because he was in the same practice as a doctor that came highly recommended to us. That doctor wasn’t taking new patients, and this guy was.
I’d never heard of “concierge medicine” or “boutique medicine” or “retainer-based medicine” or “premier medicine.” A search on Google has shown me that this type of thing is either coming to a large city near you, or is already there.
In my opinion, if my doctor doesn’t want to work with the people who can’t afford his “exceptional” services, I don’t want him as my doctor. Since when is it okay to check my wallet before you check my blood pressure, especially after you’ve already seen my insurance card?
The ethics on this seem fuzzy at best. I imagine that he has consulted a team of lawyers and experts on this, so I wouldn’t be surprised if all the necessary ethical and legal matters have been checked off on a list somewhere, but this is ridiculous.
We already pay an exorbitant amount for health insurance, and some doctor wants us to cough up an additional $2,600 a year? For doing most of the things he should be required to do anyway? During an economy that is shaky at best?
No way.
So, my task for today is to find a new doctor, one who doesn’t view us as dollar-signs. (Luckily, we have choices! Imagine how disconcerting this would be if we didn’t!) My insurance company provided a nice online list of doctors that meet our geographical requirements, and now I get to call them to find out if they have room for new patients or if they’re only accepting new customers.
Because in our current situation, we’re no longer patients…we’re customers. And, that’s unacceptable.
So, what do you think? Do you agree or disagree? Am I totally off-base here? How much would you pay out of your own pocket to continue to be seen by your doctor? When is enough, enough? Please, leave me a comment! I’m curious to hear your thoughts!
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Isnt this insane?? I’ve had some of my own doc’s go into this and it is appalling to think we’re being weeded out simply becasue we can’t (or won’t) pay the increased prices!It’s called greed and nothing less!
I know it is nuts but lots of people are switching to this kind of care. I know at least a dozen that are paying for “old fasioned” Dr. services, house calls etc. Me, no thanks, not now anyway but it works for some.
As a health care practitioner, I have always advocated that patients take the customer role in dealing with physicians. That is to say, don’t just accept everything your doctor does or says, a poor bedside manner, an unwillingness to provide detailed information, a rushed attitude, etc, etc…because he/she is your DOCTOR. Be a customer! Shop around for physicians. Fire them if they are not meeting your needs. Most people spend more time and effort buying a car or television than they would finding the right doctor.
That said, I am truly APPALLED by this idea of “concierge medicine.” WTF? What’s next, “valet paramedics?” “Members-only resuscitation?” “Processing and Handling fees on surgeries?” Sheesh!
The Hippocratic oath says, “first do no harm.” I guess it must only means physically…’cause this guy’s certainly doing a lot of emotional and mental harm to the patiens who have come to trust him.
Wonder what the proportion of prospective increased revenue is to his rising malpractice insurance costs might be?
You guys are all so funny with your outrage. I would be first in line with my $2600 if I could find a doctor who would agree to just one of these things — if I could find a doctor AT ALL! I’ve been in Ottawa 1 1/2 years now and still haven’t been able to find a GP and there is no hope in sight. I haven’t had an annual exam in 3 years because you need a GP to get one. (if your GP has time for you) Those people who do have a GP only get to see them if the doctor wants to see them. If you’re sick or have a problem chances are slim that your doctor will have time for you — you have to go to a clinic & get there early, wait 2-3 hours and hope someone will be able to see you. Most of the time the clinics book up within the first 10 minutes of opening in the morning. So you’ll have to go the emergency at the hospital and wait 8 – 12 hours. Maybe not every place in Canada is this bad –Ottawa is definitely the worst I’ve ever seen here. I could usually get an appointment with my GP in Halifax within a couple of weeks – but not always. Preventative care, counselling, cell numbers, HOUSE CALLS? Those are things of fantasy everywhere. Nothing like that is even dreamed of in the land of universal health care. Doctors are paid by the government via some insane scale; so they have to work 75 hour weeks, cramming in as many patients as they can, if they want to make good money. Most kids leaving medical school don’t want to work like that so they go somewhere else — the US probably. So there is a severe doctor shortage here, while you guys get “boutique” service…if you can pay for it. All we really have going for us is that if you have a real medical emergency, you’ll get fixed up and it’s free — you don’t have to mortgage the house to do it
I have no problem seeing medical care as a service that is subject to the same market forces other services are. Much as we would love to suspend the laws of economics for things like education and health care (“they’re a right, not a privilege!”), that’s about as futile as suspending the laws of gravity.
One way or another, limited resources (medical care) will be allocated to those with unlimited needs (patients). In a free market economy, we tend to use price as a way to allocate resources. In a centralized economy, there is some agency or person deciding who gets health care and in what priority.
If this doctor can find people who think his concierge plan is worth the price he’s put on it, power to him. He seems to want out of the byzantine maze of insurance and government third-party payments and deal directly with his patient/customers. Were I a physician, watching a certain percentage of my income and energy going to insurance compliance and records-keeping, I might do the same.
I, however, am not one of those people he seeks. I\’d find a non-retainer doctor, too.
That’s the beauty of a free market system. Producers and consumers get to choose what matches them best.
This is the first I\’ve heard of this, but I\’m sure not the last.
Cazza: Our doctor is giving us two choices: spend a large amount of money in order for us to remain under his care OR leave his practice. We’re going elsewhere.
Princess Extraordinaire: I think this whole notion that those that can’t or won’t pay are being “weeded out” is such a slippery slope!
Terra: What is disturbing to me is that we’ve gotten so far away from “old fashioned care” that we think we need to pay extra for it.
Mom In Scrubs: I agree with you! We have been choosy in the past, and I’ve left doctors that didn’t meet my standards. I’ve had no problem removing myself from a practice and “taken my money elsewhere” when the service has not been what I’ve wanted. so, in that respect, I am a customer. It’s just the feeling of only being a dollar-sign that irks me.
XUP: I knew you’d have a great perspective on this topic! Given your situation, I can understand your feelings on this, and I’m so sorry you’re forced to deal with such a terrible system. However, given the reality of things here, it’s ludicrous to spend anything extra to expect a doctor to do his/her job. Tens-of-thousands of dollars is already spent on our insurance. We personally pay thousands of dollars a year. This guy wants us to spend more? To do something he is EXPECTED to do? Fine. I’ll go to a colleague of his that won’t have a problem doing his/her job. I’ll take my money elsewhere, thankyouverymuch. It’s too bad you don’t live closer…I have a feeling he’s going to have space on his roster.
Lori: I agree with what you’re saying, but I’m just appalled that it’s happening. Like I said in a previous comment, I’ve switched doctors before, due to poor service, so in essence I’m glad to have the chance to “shop around” and “take my money elsewhere.” The other side to it to, though, is that there is something disconcerting about being kicked to the curb because you don’t want to spend money on something you shouldn’t have to pay for. Thank goodness, we have other options.
I agree with you one thousand percent, momma.
I am sure there are people out there somewhere who agree with the doctor’s new approach to health care. Thankfully, we all have the right to make our own choices and seek other options, if other options exist. The sad part about this whole concept of “concierge medical service” is it really does exclude parts of the population who probably need “personalized” health care the most. I also worry about individuals who have low literacy levels, learning disabilities, etc. How will they ever truly understand the changes that are taking place if they have to read about it in a “mass mailing”? Health care should not be this difficult, especially in a country as rich as the one in which we live.
It was interesting to see your response from
Canada where the system your doctor wants you to
be a part of sounds good!
I would immediately look elsewhere. The Denver
area should give you lots of places to look.
Joyce
And we wonder how and why our healthcare system is all messed up. Granted ours is still better than most countries…however this is not what healthcare is all about. Doctors are not just supposed to take care of you…they are required to. Now if this guy can get extra money for doing that…I guess that’s good for him. But if the system were working properly, then we wouldn’t have guys like this charging for services they took an oath to provide. After my 18 years in healthcare administration…this is definitely a new twist. I’d find another doc.
Jane: I think that’s part of what is bothering me…the idea that in order to get personalized care, you have to have oodles of money. I get personalized care from my OB/GYN and our pediatrician, and we don’t have to pay the bouncer anything extra on the way in!
Joyce: I found a new doctor! But now my medical records are being held for ransom. Stay tuned for tomorrow’s update!
Wendy: I agree! I wonder what is going to happen to all the good doctors who DON’T charge extra for their services?
I am going to ask my mom about this new type of service and see if she has heard of it. I am appalled! In our current economy the audacity of this doctor to tack on an extra price is ludicrous! I would be right there with you in finding a new doctor. There is defiantly something wrong with the Health care system if individual doctors can charge any old extra amount of money they want. As far as I am concerned they are all money hungry A-holes (Excuse the language)! I think he will find out, he will be loosing money rather than gaining money. Unless you are rich no one I know could afford to pay a “retainer fee.” If most of his patients leave, like you, it will be difficult to find new patients with the economy, which equals less money. That’s my thought anyway, I might be wrong, if he makes bank this way, I should have been a doctor (He, he)!!
Being in healthcare, this is one of the worst things I’ve heard, but, unfortunately, not surprising. I wish I could be surprised, but… Greed rules this country. I am hoping that sometime in my lifetime (hopefully sooner rather than later) I will see the day that we will value people as just that, people. I got into healthcare for one reason and one reason only. And it certainly WASN’T for the money. My first RN job earned me a whopping $11.75/hour in Kirksville, Mo and I thought that was BIG money. Now, RNs are PO’d if they aren’t making over $35. And, if that’s not bad enough, MD’s are making $500-800,000/year (I work in cardiology) and have nurse practitioners doing 90% of the work, making 20% of their salary and the MD’s are getting to take 100% of the billing. Why? Because NP’s and PA’s are not good enough in medicare’s eyes to deserve to make 100% billing – we only earn 85%. So… greedy docs want 100%. They put an addendum on the end of our notes and boom – they’ve done the work and get 100%. And we get chump change for doing all of the work. It sucks, it’s not fair and something needs to change. And, unfortunately, even though docs get 100% billing, that really isn’t all that much. An admission to the hospital for congestive heart failure is the most common medicare admission diagnosis in the US. The payment for that is under $10,000 (how much depends on which state you live in). The actual cost for that admission? Probably in the neighborhood of $25,000 (depending on how sick the patient is). And, according to medicare, if that patient gets discharged and then re-admitted within 30 days, the hospital and the doctor get $0 because WE haven’t done our job. Doesn’t matter if the patient couldn’t afford the meds, didn’t follow directions, etc. It’s the health care providers fault and that’s that. This system is f’d up (excuse my french – I tried to leave out as much and still get my point across). It is so appalling to me that I can’t take it any more. I’m leaving hospital based health care and moving to private practice clinic. We control prices/costs/care. And, as horrible as I think this concierge medicine is, it would allow me to practice the way I think medicine ought to be. Momma, you are VERY lucky that you haven’t been rushed. I have seen practices where you have 12 minutes of your 15 minute appointment (the other 3 are reserved for the provider to dictate your visit). You are allowed 1 problem per visit (or per co-pay however you see it). There is no time for education, no time to get to know each other. For men it’s turn your head and cough and for women it’s scoot to the end of the table, okay we’re done. Out the door, see you next year. If I was forced to be in that type of situation (on either the patient or the provider side) $2600 would be a small price to pay to get what I need to be healthy.
Jess: Thanks for your comment! I wonder what your mom thinks about all this? It’s just crazy!
Christy: I appreciate you taking the time to comment! I love hearing stories from the other side of the exam room. I’m sorry you’re having to deal with such situations. I guess that’s why I was so taken aback by these developments…we haven’t had those issues! In fact, had we not been satisfied, it wouldn’t have been too difficult to switch to another practice. (Like I said above, changing would be annoying and inconvenient, but definitely doable. In fact, I found a new practice today, and I’m trying to get my medical records released. More on that in tomorrow’s post!) Anyway, I really worry about where we’re headed with healthcare. I wouldn’t want to give up the relationship I have with my OB/GYN nor our pediatrician. But, if finances stood in the way, I’d have to find someone else. I’d be sad, because we really are seen as PEOPLE to them and not a NUMBER, but we have to do what we have to do. This has been a huge wake-up call.
The only comment above that really gets it is from Canada, which is even farther down the road to destruction of primary care than we are.
As president of SIMPD, the Society for Innovative Medical Practice Design, the professional society open to all concierge and other direct practice doctors I want to confirm that the reason health care is so fragmented and disrupted today is the lack of excellent primary care America once had. That fact in large part results from the devaluation of primary care and its extremely low pay status under the third party and Medicare dominated payment system under which we now suffer. It will soon get much worse.
The Physicians Foundation survey published recently indicates that 100,000 primary care doctors, of the estimated 250,000 we now have, will close their practices in the next 1-3 years because they cannot make a living in the insurance based system working 80 hour weeks. That same survey indicated that about 18,000 primary care physicians will convert to concierge medicine direct practice in the next 1-3 years in order to survive and deliver better care.
Medicare over the past fifteen years has cut reimbursments to primary care doctors over 50% in real dollars. Next year it is set to cut that reimbursment another 20%. That is unsustainable.
Primary care doctors are tired of running on a hamster wheel and getting farther and farther behind with each step. As recently as ten for fifteen years ago 50% of medical students went in to primary care residency programs after graduation. The figure this year is down to 2%. Nobody will be left soon if patients do not recognize that good primary care is not an insurable event. If you want such care, as the Canadian above does, you will have to pay for it. The cost averages $5.00 a day. This is about the price of lunch at a fast food outlet.
The concept of “medical home” is a critical one. Every American needs one, a place they can access top notch primary care immediately and fully like one can access a concerned family member. And they need to buy that home directly, not with other people’s money. When they do so the cost can be very low to the patient and the benefits very high to patient, primary care doctor and society.
The only payer willing and able to pay what a medical home will cost is the patient. Interest in concierge medicine is therefore rapidly growing. Starting with the first such practice about twelve years ago in Seattle and growing exponentially, there are now thousands of such practices in the USA, some are associated with franchises though most are independent. No mater what the government does, that is where the action will be in the future as our numbers grow from the current thousands to tens of thousands to hundreds of thousands.
Direct practice doctors and those who wish to adopt the direct practice model can join the society and get many benefits including up to 55% discounts on malpractice insurance, practice marketing help, national care networks and many other services. Our society is rapidly growing its membership. Direct practice doctors have much more time with their patients,and virtually never get sued because the care is so much more detailed and careful.
Patients can go to SIMPD’s web site at simpd.org for information and to find such a doctor in their own community at the “find a physician” link. This is the ideal way for patients to get personalized, prompt, excellent primary medical care in a unhurried, pleasant setting. Money is actually saved on patient care in such practices because emergency room visits and hospitalizations are drastically reduced due to of the personalized, immediate, detailed care we deliver. The cost of concierge care, which averages about $150 per month, can be as low as $40 per month. This is affordable for most Americans, while the fragmented primary care most are now getting through employers or government third party interference in the doctor patient relationship is penny wise and pound foolish.
SIMPD believes most Americans can eventually be cared for in such direct “medical home” practices resulting in far better care. This will result in lower overall cost and a return of interest in primary care by students who now shun the field as undervalued, underpaid and undesirable compared with other medical specialties which for the same or lower levels of training and effort often pay double and tripple what primary care pays inside the insurance system.
If any of you have further interest please contact me through the SIMPD web site. I answer all emails through that site personally.
Thomas W. LaGrelius, MD, FAAFP President, SIMPD simpd.org 877-448-6009
Owner, SPFC Torrance, CA skyparkpfc.com
Dr. LaGrelius,
Thank you for reading the article and commenting. I respectfully disagree with the type of medical service you are providing. What if the patients can’t or won’t pay? Something seems very, very wrong about that approach. Eventually, the doctors unwilling to charge their patients extra will be forced to take on more and more of a workload.
Not to mention, my husband and I already pay premium prices for insurance that pays our doctor handsomely for his service.
But, it’s a business decision doctors need to make. Personally, I want to see a doctor and not a business-person. I am so thankful that I have many choices at this point, and I just hope that the doctor I’ve chosen (and my gynecologist and pediatrician) do not follow suit. They have found the balance between giving me the personalized care I deserve for my money (that we are INDEED paying) and being the good, caring doctors they took the oath to be.
Again, thank you for sharing your perspective!
I popped over from Panther’s site, and would feel as dismayed by this development, if I heard the same thing from my doctor as well.
At the same time, working with as many physicians as I do, I can understand the motivation to move toward this type of system – I’ve seen the reimbursement side of medical care and it isn’t pretty. Between the paperwork, the involved the cost per dollar of actual reimbursement, it has caused many physicians to face serious financial trouble.
I notice one thing about your concern that keeps catching my eye – “my husband and I already pay premium prices for insurance that pays our doctor handsomely for his service.”
Maybe this is the problem.
Maybe we need to completely overhaul how we view medical insurance.
Maybe that “boutique doctor” will be a new form of insurance (right or wrong). Maybe insurance will be more like how many people retain a lawyer, with patients paying additional fees as needed, for care, not relying on other insurance to cover costs. Maybe insurance as it is seen now should only be used for major medical.
I’m not saying this is right, but I’ve seen both sides. And I don’t have the answer.
RC Rambles: Thank you for taking the time to comment! I think you’re right about some overhauling being needed, and I’ll take it one step forward and say that it’s not just way we *view* medical insurance, it’s the whole medical insurance industry. But, that’s another rant for a different day.
The reality is that our insurance is what it is. This doctor is trying to charge us extra for something that he’s already (and should be) providing.
To me, it’s as if we’ve already paid for our plane tickets, but now the Pilot has sent us a letter telling us that we can’t fly on his particular plane until we pay a Membership Fee. With this fee, he will personally see to it that we have seats on the plane. He will take off and land the plane appropriately. He’ll be sure he goes to the correct airport. As premium members, he will see that we also receive a tasty beverage. We can also have his cellphone number if we have any questions.
See what I mean? When I get on a plane I expect to have a seat. I expect it to go to the correct airport and for it to take off and land properly. I bought the tickets! That comes with the price of a ticket!
I don’t really need to fly on HIS plane. I’ve purchased the tickets, so I’ll fly with a pilot that doesn’t charge me extra.
Again, thanks for the comment! These systems are definitely broken, and I don’t know how to fix them either. We’re just along for the ride.
An interesting article and responses. Dr. LaGrelius points out the lack of primary care physicians. Twenty six states in the US now recognize a nurse practitioner as a primary care provider. Primary care is the thrust and scope of practice of most NPs in this country, and there is a movement to increase these NPs to fill this role of primary care provider.
This does NOT replace physicians – instead, NPs provide a needed service and make appropriate referrals as indicated. I know of several NP practices around the country that cover evening, nights, and weekends, and also cover home visits and coordination of other services that are being advertised in the concierge-type plans. For all consumers: check to see if there is a qualified NP in your area to help provide these services. Again – please note that an NP is not “pretending” to be an MD. I know full well the differences in education and skill. Still, an NP can tend to about 90% of any problem that may be seen in any office.
As for paying for services: I have to agree with Dr. LaGrelius’ comments that some of the costs must be carried by the consumer (patient, customer, whatever term you like). The health care system is not working for millions. Changes will take place over the next few years (or decades) that will alter the way care is delivered and accessed. Concierge services is just one sign of this change.
A savvy consumer will keep informed, find suitable alternatives, and shift their plans for receiving health care to the most appropriate service and provider.
I wish us all well as we experience changes and modifications in how we receive and experience health care services. The writing is on the wall – - evaluate alternatives and invest in options that meet our needs.
Thanks
NP: Thank you for your response! I’ve always had good luck with Nurse Practitioners, in a variety of specialties, whenever the regular doctor wasn’t available. They’ve worked closely together, and I never felt slighted in my care. It will certainly be interesting to see where this all leads!
Not sure where the original poster is from…but here in southern calif the costs for this type of practice begin in the range of $5000 or more…(they visit you in jail too!!)
as for the comment that “my doctor is already reimbursed handsomely”…perhaps next time you get an EOB you need to compare what your doc is getting…usually it is a pittance of his charges..
just an opinion…this was bound to come..for both the docs who don’t want to see 4+ patients per hour…and the patients who are willing to pay for better attention
Rosemarie: Thank you for stopping by the blog and commenting! I am in the Denver area. Here in Colorado, this type of service is relatively new, as you can see by the comments above and also at The Denver Post’s Hot Topic Link:
http://talk.milehighmamas.com/viewtopic.php?p=644506#p644506.
I have seen our doctor’s bills, and the insurance matches what he’s charged. Like I said, we have excellent coverage. I know not all insurance coverage is the same.
Interestingly enough, one of my close friends lives in a different city in Colorado, and she said her doctor recently went to a concierge practice, only that doctor said her practice wasn’t for those who are healthy and only see the doctor on rare occasions (like my husband and I do…we’re healthy and only see him for our annual exams and if there’s a situation that has arisen…we’re not chronically ill), and the doctor encouraged her to find a different practice. Thankfully, we have choices and options here.
I think we all agree that the system(s) are broken.
Thanks again for commenting! I love hearing everyone’s perspectives!
reimbursed what they charge??
in what world is that
I have excellent PPO coverage..for me..hubby is on Medicare thank god..
my doc is lucky to get about 60% of the “usual and customary” charge..and he is in network..
ever had surgery?? hubby’s CABG hospital bill ALONE (not counting docs anesthesia..etc) was $60,000 or so…hospital got a measly $14,000 since they “accepted assignment)…we were not billed for the difference
sorry…them’s the facts..at least here
rosemarie b
Rosemarie, I believe you! What’s happening with insurance is another writing piece in and of itself! The system is so broken.
Thankfully, we haven’t had extensive hospital stays or surgery (knock on wood!), and my doctor really has been reimbursed for what we’ve been charged. I know that a lot of insurance places don’t cover the full cost. I’m not sure who is to blame for the price of the charges: malpractice insurance rates, overcharging by doctors and hospitals, or underpayment by insurance companies. I have a feeling there is a lot of finger pointing in that Catch-22.
But, like I said, my point was I’m not going to be forced to pay for a service I can get somewhere else for what I’m already paying. That’s the bottom line for us. I worry about the people who don’t have good doctors to choose when they’re put into this same situation…
Thanks again for the comment!
Momma…and all others
sorry…but we have had excellent PPO coverage for many many years…and NEVER has the provider,,xray..labs etc…been reimbursed at what the bill indicated…as I said…mostly it was in the neighborhood of 60% of the bill..and here in Calif…insurance companies use the same stats as Medicare…so reimbursement is the same …
here..those docs who go to conciege in most cases do NOT take non coniege patients..thus the $5000 or more per year..yes they do bill insurance
recently we had dinner with a 60 year old ENT friend…he says he is “making” less than 50% LESS than he did 20 years ago (no..his rates have not gone up..but his reimbursement has tanked)..for instance…for a tonsillectomy he now LOSES money..as he get $100 per..takes him away from his office minimum of one+ hour..during which time he could do 3 consults..etc…he is thinking of NOT doing tonsils anymore
as for the gov’t bailing us out…HAH..while I surely feel that healthcare is a RIGHT not a privilege…universal health care will likely throw us into the pool with countries such as Canada,,and England….long long waits for NON emergent care..and all kinds of rationing…etc..not that we here should be doing open hearts and transplants on those whose lifespan is at best 10 years…but Americans will not tolerate such…
as for costs for copying files etc…don’t know where you have been..but this has been common for as long as I have been an NP…owning your records,,HIPPA etc does not mean the providers etc have to pay for the paper,,clerical time etc…
so glad I am old and retired…tho I just found out that when I turn 65 in June…my Medicare will cost me 94 a month…and my supplemental (PPO>>no meds) will add at least another 150 a month
good luck
rosemarie
I want to say beware. Just because someone promises certain benefits and you pay money, does not guarantee it will happen.
Both my husband and I saw Dr. Lagrelius for almost 5 years and both paid the concierge fee for 1 year. For the proposed benefits, it sounded great. Unfortunately, it was not great at all. Just don’t assume because someone promised to provide certain benefits that it will happen, even if you pay money.
I am sure I needed surgery for over 3 years and went undiagnosed. As for my husband, he was referred out to two different doctors who really let us down. We should have seen as attorney but I don’t have time to waste, just beware.
Former Patient of Dr. Lagrelius, I’m so sorry to hear that!! Thanks for the warning!