My friend and Better Health contributor, Toni Brayer, recently polled her blog audience about their opinion of concierge medicine. She describes concierge medicine this way:
Also known as “retainer” practice, concierge is a growing type of medical practice where the patient pays the physician an up front fee (retainer) for services. The fee can range from $100/month to $20,000/year, depending upon the practice and the services offered. The fee usually covers all visits to the doctor, phone calls, more prompt service and email access. Labs, tests, Xrays, referrals to specialists, and hospitalization are not included.
Her readers responded:
- 59% of readers agree with the principle of concierge and would pay the retainer if they could
- 21% think it is “elitist” and unfair
- 18% don’t have a clue what “concierge medicine” is
I think the concierge model doesn’t accomplish what we need in health reform – expanding the primary care base. It actually just decreases the common person’s access to physicians.
My practice uses a “pay-as-you-go” model with time-based billing. That means that I charge for my time only – I can do house calls, office visits, small procedures, webcam visits, email, phone calls, texting… Whatever is both appropriate and convenient for the patient.
Patients end up needing 10 minutes of my time in many cases – and spend $300/year on their primary care needs. This allows me to see more patients, streamline my practice with technology, save people money, and have fun in the process.
I predict that my practice model will eventually overtake the concierge approach in popularity because it’s less expensive and solves the access problem. Of course, it is cash-only… if patients want to submit claims to their insurers for reimbursement they can go right ahead. But when a visit with me costs about the same as some copays… why bother? In my opinion, people should just switch to high deductible plans and pay cash for primary care.