Healthcare and how it’s provided in the United States has been a hot-button issue for years. At times, people are left with few options or, worse, options they can’t afford. But there may be a solution out there that you haven’t heard of — and you haven’t heard of it because the insurance companies don’t want you to. It’s called concierge medicine, wherein a physician provides direct personal care without insurance.
Many people are taking advantage of its benefits.
What are concierge doctors?
According to Dr. Sherika Newman, who runs the on-demand concierge medicine service Montgomery Medical Associates in Atlanta, concierge doctors provide services not covered by medical insurance by having the patient pay what’s essentially a retainer or “membership fee.” Patients typically receive more personalized care and hassle-free access to these doctors because they’re paying for it out of pocket — which, it’s important to note, can become quite costly if you’re going to the doctor frequently.
“Examples of extra services include extended office visits, same-day appointments, calling patients with lab results, and making house calls,” says Dr. Newman, who completed her family medicine residency in 2008 and a fellowship in hospice and palliative medicine at Broward Health the following year.
Concierge doctors are able to do this because they’re not slaves to the insurance system, which, according to Health Journal, requires doctors to get patients in and out as quickly as possible in order to make a decent wage. In contrast, concierge doctors operate with smaller patient rolls — so they can spend more time with their patients.
How do concierge doctors work?
Patients join the practice as members and pay a membership fee.
“This membership gives the patient access and services that are not usually covered by insurance programs,” Dr. Newman says. “The patient’s insurance will continue to pay for the services typically covered.” Anything outside of that, as treated by the concierge doctor, will be the patient’s full responsibility.
Your concierge doctor will take the time to get to know you, too.
In an article on Kiplinger, contributing editor Lisa Gerstner explained why the opportunity to build a relationship with a doctor is a top selling point:”
Your annual physical may include preventive procedures that insurance plans are not required to cover under the Affordable Care Act, such as an expanded blood panel and screening for Alzheimer’s disease. Louis Malinow, a Baltimore internist with a concierge practice, says that he is able to give patients quicker diagnoses. For example, he was able to order tests and read the results in a matter of days for a patient with possible metastatic cancer, then arrange a biopsy that showed the patient had a much less serious condition. The process would likely have taken weeks at his former practice — and left the patient anxiously waiting results for much longer.
How can concierge doctors benefit the patient?
Have you ever called your primary care physician when you’re ill, but they can’t see for you for two months because they’re booked to the gills? It’s a very dark side of the insurance system — and as a result many patients don’t get the care they need when they need it. This, in turn, causes many people to wonder why they’re paying for expensive insurance premiums, and question if they’re really getting their money’s worth.
According to Dr. Newman, most patient complaints are waiting too long for an appointment, too-brief doctor visits, and having to return to the office for lab results or charge for form completion.
“This is all time-consuming for the typical busy American,” she says. “Being a concierge patient means getting the services and treatments we all desire from healthcare without the hassle or bureaucracy from an insurance company. I’ve found that patients are willing to pay for what they want.” And it becomes even more convenient whenever a concierge doctor is HIPAA texting compliant to patients.
Why don’t insurance companies want patients to know about them?
It’s all about the money. While concierge practices accept insurance, the extra fee you pay provides an extended level of care, which means that concierge doctors can’t and won’t churn the oversized patient rolls that insurance-only physicians can — that resulting patient deficit represents a substantial loss to the insurance company.
More than insurance companies, however, it’s the direct primary care (DPC) practices that want to keep you in the dark about the concierge option.
“DPC is similar to concierge because members still pay a membership fee, but DPC offices don’t accept insurance,” Dr. Newman explains. “They cut out the middle man and deal directly with the patient. All DPC services are covered in the membership. The patient may still need insurance for specialty visits and hospitalizations.”
Photo Credit: Walt Stoneburner
Concierge Doctors are not available in most places in the U.S.
“Most practices are heavily concentrated in urban areas such as New York, Washington, Los Angeles and Miami. If there’s not a practice within easy reach, it probably doesn’t make sense for you. ”
https://www.aarp.org/health/healthy-living/info-01-2013/boutique-doctors.html
My doctor is a concierge physician and he only takes 1 insurance….Blue Cross. If a member becomes eligible for Medicare he accepts that, however he doesn’t take new patients on Medicare. When I walk into his office, there are not 50 other people in the waiting room. Many appointments last an hour. My doctor is more about preventing me from getting sick instead of treating an ailment once it occurs. Sometimes this is actually annoying as he has more time to think about a course of action and is always encouraging (nagging) me to lose weight exercise more, eat different etc. On the other hand he responds to e-mails and has answered my call while he is on the ski slope on vacation. He is a better doctor than I am a patient.
All its going to do is clog emergency rooms!!! Greedy drs that claim its to give better care!! To whom??? The rich only!!! Once again the rich get to b healthy and kill off the poor!!! Just a way around president Obamas healthcare. What happened to compassion? What happened to saving peoples lives? What ever happened to the hypocritical oath? All about the money!!! I don’t need an hour with my dr!!! I just need to be well!!!
Please. Stop with the socialist class-warfare propaganda.
Obamacare has been an unmitigated disaster. Before Obama screwed things up, I was paying $800 annually for employer-provided healthcare that covered my entire family. By 2019, I was paying $8000 for the same coverage. Yes, ten times more. If you believed the lies the Obamacare proponents were peddling, we were all supposed to be saving $2500 per family per year. Of course, only the gullible truly believed that.
Obamacare is great if you don’t have a job … that’s because people like me have to get up and go to work everyday and pay not only for my family’s healthcare, but two or three other families too. If you ask me, anybody who thinks that is somehow fair are the real greedy ones.
Obamacare has problems because of republicans. They have been trying to destroy it since it’s inception. And voters refuse to take responsibility for it.
We pay more than any other industrial nation. In fact our quality of care is at the bottom of the list. A previous doctor I had went with such a service and the monthly fee was $1000 a month plus they still charged the insurance company and a copay. Also you are still responsible for hospital and lab fees and specialists costs if they are not part of the service.
If the medical community had paid attention to what was going on and stood up to insurance companies in the late 80’s and 90’s and voters started paying attention to the facts and made sure that they elected representatives that served them we would not be in this position today.
HMO’s and for profit insurance destroyed our quality of Healthcare. Just think, a retired couple could be paying $2000 a month for access to a doctor plus any other fees that are not covered.
In addition, if your doctor leaves or retires, you can be assigned another doctor without your approval because your healthcare is owned by the concierge service. I see my pcp for an hour each time I see her and I never wait more than a couple minutes. She schedules her patients based on their needs. It is disgusting that another expensive insurance company is working to increase their profits by offering access to a doctor that did all that we had previously from doctors and the insurance industry destroyed.
As I see it, Obamacare was dead upon its inception, C. My only fault with the Republicans is they failed to repeal it when they had the chance.
My parents lost their long-term doctor shortly after O-care was implemented (despite those incessant promises from the O-care advocates that “if you like your doctor, you can keep your doctor”).
My HMO is Kaiser; they were a huge proponent of Obamacare. Well, they got what they wanted. Now they have more people on the rolls than ever – in fact, too many to handle now. As a result, the quality of service has completely disintegrated, while prices have skyrocketed. So Obamacare essentially destroyed my HMO (although I am sure all of the newly-added subsidized Obamacare patients that are now part of Kaiser think it’s just great).
As for Obamacare’s biggest crime: Making catastrophic health insurance illegal. Before Obamacare, young people (who really don’t need traditional comprehensive healthcare) could get a catastrophic policy for about $30 per month. Not any more. Now everybody is forced to pay for their subsidized – and wholly-unnecessary – FULL-SERVICE Obamacare plan. Ain’t government run healthcare, grand?
In the end, Obamacare not only failed to “fix” a problem that didn’t exist, it ruined our healthcare system. At least that’s my POV.
My primary doctor is in the process of moving to the DPC model. I would pay a yearly fee that is based on my age. As mentioned, insurance is not accepted.
I am still evaluating. Cost wise the only charge I currently have is my twice a year copay which is around 10% of what the yearly fee will be so it doesn’t really make sense.
But, he has been my primary doctor for the past 18 years. He knows me and I like him. I’m sure I can find someone but this has turned out to be a more difficult decision than I thought it would be.
You’re right. I for one have never heard of concierge MDs. Wonder if they’re available in my home state of Illinois. I do like the availability factor, but I’ve seen a lot of what we call “immediate care” clinics all over my area now. How about membership fees? Do they vary by clinics?
My sister’s sick for weeks now and she still can’t figure out why. It was discussed here that concierge doctors do extensive care and take time knowing the patient compared to those under insurance. Furthermore, it’s recommended to go to trusted concierge doctors for quality health care.