May 3, 2013

Concierge Medicine: So What Do YOU think?

I've been writing this week about concierge medicine, prompted by a letter I received from my longtime internist announcing that he was joining the many other primary physicians switching to that model. I can stick with him and get more personalized care . . . for an annual "membership" fee of $1,500.

I'm still debating whether to go this route. Yesterday, I described my initial thoughts. Many of you have already dealt with your internist's switch to concierge medicine. The rest of you may well be confronted with this decision in the near future.

I'd love to know your thoughts. I've already benefited by hearing from some of you. Here's a sample of those emails and blog comments.

Comments from Others on Concierge Medicine
From Carol A.:
If you can find a boutique geriatric specialist, it might be worth the price  -- especially since more and more drs. are declining to take any more Medicare patients . . .
That said, I do think there’s value to having a primary internist who serves as central command – someone who knows all your miscellaneous health conditions, your complete medical history, all your current meds, all the past meds you tried that either didn’t work or had adverse reactions to, etc. 
That’s one thing I like about my MD – even though he’s recognized as a top diagnostician and specialist in the endocrinology field, he takes his role as internist seriously enough to request info on anything I have done elsewhere that’s of any significance. That way, if I’m ever hit by a bus or otherwise incapacitated, there’s someone who has a fairly complete file ready for whatever medical professional might need it – w/o having to contact, wait for callbacks, and piece together info from a dozen different specialists who only have a slice of the picture.
From Allen T:
I've gotten the same pitch from my last 2 primary care docs. I suspect some kind of management company pitches it to the doctors and gets a piece of the pie when people sign up. It kind of reminds me of toll lanes: you pay a premium to get what everyone should be entitled to. I think it's a rip-off.
From Kathy M:
My internist in Northern Virginia did this several years ago, reducing his patient load from 4,000 to 600 rather than giving up medicine entirely, and I stayed with him. Then the internist I selected on Cape Cod did this, in order to have better work/life balance as he nears retirement, and I stayed with him too. I count myself fortunate to be able to afford the $1500 annual fee, which is money well-spent for the kind of access and care from an excellent doctor that everyone should be able to have. For me, it's a matter of priorities. I don't belong to a country club, fitness club, golf club, tennis club, or yacht club; in effect, I belong to a concierge medicine club. But for those whose household budgets really do not cover the fee for concierge medicine -- even if they were to give up luxuries like deluxe cable, latest electronic gadgets, eating out, mani/pedi/hair care, and/or other treats that can easily cost $125 per month -- concierge medicine is an unfortunate development that can mean a door slamming in their faces.
From David K:
I'm dealing with my back...arthritis in four vertebrae. My old doctor didn't deal with the problem...just gave me pills to mask the symptoms. His office is now a concierge service for $2,000 per year + insurance. Too much in this uncertain economy so I went looking for someone to deal with the problem.
From Judy M:
My internist did the same thing. One big advantage is that he will coordinate my care if I am hospitalized. I decided to join, at least for the first year.
Here's How You Can Join the Conversation
This is a big issue as we all try to deal with the rapid changes in medical care.

I'd like to learn more by hearing from others. Here are two ways you can join in:
  • At the bottom of this post on the right, there's a "Comments" button. Click on it and you'll open a box where you can leave a comment. You are asked to provide a name but you can make one up or just say "Anon" if you don't want to use your real name.
  • If you have my email address, send me an email. Unless you ask me not to, I'll post it as a blog comment, but I'll use a fictitious name unless you tell me it's OK to use your real name.
We'll all benefit from getting a diversity of opinions on this topic.


Jane B. said...

Hi. Quick advice. Sign up before his concierge practice is full and you are out of luck. When Ted Li (also of Foxhall Internists) decided to become a concierge physician, his practice was full in about six days. Life should not be this way but it is. Doctors do not get paid reasonable amounts from Medicare to pay for office staff, rent, etc. let alone college tuition. If you can afford it, do it.

You can always change your mind a year from now.

Jane said...

Hi John,
Just a comment about concierge medicine.
My mother moved here last year and because she has several healthcare issues, we chose
Dr. Lila McConnell who charges the $1500 fee.
I can tell you that it has been worth every penny of the quarterly $375 fee. We have access to
her cell phone which she answers when we call. If we call the office, she calls back very promptly.
When my mother fell, she met us at the hospital and made sure all was ok, though she was not required to do so. And when we go to the office, my mother never waits more than 5 minutes to be seen.
Overall, a very positive experienc

Sally said...

Dearest John:
I have two words for you and all--Kaiser Permanente.

Michael said...

My GP in Washington, DC did this, too (before my retirement). I informed him that I didn't want to participate and then continued going to my out-of-plan doctor.

At some point, though, when my official out-of-plan doctor was on holiday, I called my concierge (previously in-service) doctor again -- and discovered he was still willing to take me on via Aetna at the in-service deductible rate and fee. I had a feeling most of his patients told him to take a hike. And I wouldn't have found out had I not called him to check to see if he would be willing to see me.

Your experience might be different, but I just wanted to share what happened with me.

Helen said...

Here's another twist on concierge medicine. My mother is 92 and lives in Florida. A few years ago her long-time internist switched to a concierge practice, and she opted to pay a six-month fee and stay with him. A few months later, she got another letter from him saying that not enough people subscribed so he was closing his practice and refunding money to make up for the time not covered yet.
Mom switched at that point to an internist who would accept Medicare and has been pretty happy with his service. He works with a nurse-practitioner who screens critical-care needs, and when Mom had a bleeding ulcer on the occasion of her 90th birthday, the NP was fabulous at getting her to go to the hospital immediately.

Jim said...

John, my primary care physician switched to the plan a couple of years ago and, while employed, ITA paid the $1650. I decided NOT to continue it for two reasons; first, my health was pretty good and I didn't anticipate needing such ready access as the 24 hour guarantee to see him, secondly, he was about my age and I figured I needed to find a younger physician anyway. I found a new guy at Johns Hopkins Physicians located in several areas around town. I am not convinced that their system is actually equivalent to what Dr. Yerg provided me but, for now at least, I am remaining with the doctor that I changed to.