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Concierge Medicine: Is it for You?

Weary, overwhelmed doctors in increasing numbers are turning to a concierge medical practice to escape the stress of what they feel is ‘conveyor-belt medicine’: seeing too many patients in too short a time.   Patients requiring extra attention with chronic and complex health problems are turning to concierge care to guide them through a medical maze of specialists and treatments.  Others, tired of long waits and impersonal care and willing to pay extra for their health care are finding concierge medicine the answer to their prayers.  The doctors converting to a concierge style of delivering health care are part of a small but growing trend.

How is a concierge medical practice different than what we have today?  Concierge doctors limit their practice to 100-500 patients instead of the 3000-4000 patients the average doctor sees.  With fewer patients, a concierge doctor has more time to deliver personal, unhurried care along with individually designed preventive care programs and treatments.  Their patients, in return, pay an annual fee to compensate the doctor for limiting his practice.

I was unaware of this medical practice until May of last year when my husband received a letter from his excellent internist, Dr. Michael Yu, announcing his new ‘private’ medical practice.  Dr. Yu explained that changes in health care were pressuring him to see more patients.  He felt more time with patients was necessary for the best care; and this was becoming less and less possible.  To solve the problem he was inviting his patients to enroll in his new practice.  An enclosed booklet listed what a patient could expect from Dr. Yu upon enrollment:

·    annual comprehensive physical exams & wellness assessments
·    limited patient enrollment
·    extended office visits
·   preventive care focus on early detection and treatment of heart disease, diabetes, and cancer
·    24/7 physician availability
·    same day or next day appointments
·    coordination of referrals to other medical specialists
·    dedicated phone and secure patient internet access
·    (and more…)

Those who wished to be part of this new arrangement would agree to pay $2000 as an individual or $4500 for family coverage.  To those who declined, Dr. Yu offered the names of 4 other respected internists who agreed to accept Dr. Yu’s patients.

Honestly, I wasn’t surprised that Dr. Yu would go in this direction. Dr. Yu prided himself on personal, unhurried office consultations and thorough examinations.   He spent much time with my husband, researching and evaluating various approaches to relieve his life-long digestion problems.  My husband appreciated Dr. Yu’s unhurried office visits and the follow-up calls he made to evaluate results of treatments.    I assumed he did the same for all his patients and wondered, at the time, how he managed such a workload.

Although each concierge medical practice differs in services, fees, and organization, Dr Yu’s new approach follows the typical structure of the concierge model.  While annual fees are typically $1500 – 2000 a year, they range from $60 to as much as $15,000.  The fee, however, is not a substitute for health insurance and won’t cover consultation with specialists outside the practice, hospitalizations, medications or lab work.

So who are the people willing to pay $2000 a year plus the cost of their regular health insurance for health care?  It’s not just the wealthy.  For some, it’s a matter of value.  A recent health care study shows 40% of patients feel the quality of the medical care they’ve been receiving has declined over the last 5 years.  Crowded waiting rooms, long waits for appointments, hurried and impersonal office visits and increased use of nurse practitioners and physician assistants are some of the reasons given.  Validating this, a Kaiser research study reports that the average patient spends just 10 minutes per visit with his or her doctor.

For others, however, it’s beyond basic health care; it’s a matter of life or death.  People suffering from chronic health conditions like heart disease or diabetes often have many more problems and must see a myriad of specialists.  A concierge doctor can coordinate all that care, prevent conflicting treatments and drugs and be immediately available if health conditions change unexpectedly.  People with a family history of disease who face an uncertain future might find reassurance with a concierge doctor who’ll provide the extra tests and monitoring necessary for early detection and treatment.  Membership in national concierge associations offers additional support by giving concierge doctors and their patients access to the internationally renowned medical centers of Johns Hopkins, Mayo Clinic, Sloan-Kettering Cancer Center and others.

My husband chose not to accept Dr. Yu’s offer.  He’s in relatively good health and, despite his digestive problems, sees doctors infrequently.  But, after  a year and a half, he still hasn’t found another doctor to his liking.  $2000? – It’s a lot of money; but to someone requiring extra attention, it could provide priceless peace of mind.

If you’re interested in learning more about concierge medical practice check out a 2010 study of concierge medicine conducted by University of Chicago and Georgetown University.  Information about concierge practices near you can be found on the websites of the American Academy of Private Physicians (AAPP) and Medical Doctors Value in Practice (MDVIP).

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