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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