Have we discussed "concierge medicine" yet?

[Rick Lee]

Around 2008 I got a letter from my doctor in VA that he was leaving the medical group he was with and going concierge. It think it was a $1500 annual fee, no insurance accepted, but you get personalized service, direct access, no long waiting periods for appointments, etc. I was moving to AZ, so I didn't care.

Just got the same letter from my doctor here, whom I really like and whose medical group I really dislike. This letter didn't mention pricing or terms and conditions, said that letter is coming in a month or two. I don't know that I use enough medical care for this to make financial sense to me. The new office would be a 15 min. instead of two min. drive from my house. I go in twice a year for blood work and script refills.

Anyone here been through this? Is it worth it?

[id10t]

Mom leased her office for just over a year to a doc that was trying to set up, and never got a single patient .... Then again, doc had bad business plan, etc. and was "acting out" probably after her divorce (from a very good surgeon)

[masraum]

Are the regular charges less than they'd be if they weren't concierge?
Or are you still paying the full amount for services, except that now, the Dr hasn't accepted the Ins co terms of service to be "in network" that says "you can't charge more than $X for service ABC123." So now the Dr knows that because you paid $1500, you'll go and pay no matter what they charge.

You'd think it might be a way to simplify things, but it also sounds like a good way to get doubly screwed. There would have to be very clearly spelled out specifics.

And if you go to the Dr and you have to get bloodwork or an X-ray or MRI, well, that gets sent somewhere else or done by someone else, so even if you're getting better prices from the Dr, do you get screwed by the cost from those other people (that insurance would probably cover at least partially).

[masraum]

It hadn't clicked for me, but "won't take insurance" is not the same as "can't claim on insurance." I guess it's possible that the Dr won't take insurance just means that if you want to claim, you have to pay, then claim to your insurance and get reimbursed. Of course, that sounds like an enormous PITA.

[Rick Lee]

I think he'll still be loosely affiliated with the medical group he's leaving, so the bills would likely still come from Honor Health, LabCorp, etc. It's just that I'd have to pay them with my Amex and then get reimbursed by the insurance co. I would think the charges would be lower, since he'd not have to have a large staff to handle the insurance BS. The current office never has fewer than five women at the front desk, handling phones, check-in and billing stuff.

[greglepore]

my gp left his practice at UVA and does this - 1200/yr, billed 100/mth. He spends about an hour with you on each visit, chewing the fat about everything, from which he likely learns a lot. Says, use your Medicare for specialists etc if needed. Haven't signed up yet but likely will.

[Rick Lee]

I can't imagine using $2400 worth of his services in a year. I may pay $100 for each appt., which is about twice a year, maybe the same for lab work, which probably wouldn't be covered by his annual or monthly fee, and I still pay for my scripts. I have a colonoscopy next week. Last one I had, I think my out of pocket was $180 and it was obviously done by a specialist. I'm not seeing the value here, other than I really like the guy and he's as punctual as a Swiss watch. No, wait. Sometimes he's even early.

[Noah930]

You sound pretty healthy, Rick. So not worth it for you.

But if you're one of those who always goes armed with a page of questions for your doctor (you know, inspired by stuff you read off the internet) or the type who calls your doctor on a daily basis, then concierge medicine is for you.

[Gogar]

I have one and it is quite a bit more than $2400. Ex Ms Gogar talked me into it.

At 51 with relatively few (physical) problems It seems impossible to get the value out of it.

I get a little frustrated at his hesitance to just diagnose and treat me, and his quick willingness to refer me to a specialist for practically everything. I had some lumbar back pain and he wanted to refer me to a back surgeon straight away, no thanks.

The plus side I will admit to is I can call in the afternoon on Tuesday and get seen Wednesday morning.
I did notice as well for referrals that I could get seen at the referral in a day or two as well. Still not enough to justify it.

My 76 year old mother with the basic old-lady issues has a concierge doctor more in the $2-3K price range and she loves it.

It certainly seems the Elderly, the chronically ill, the rich, and the fretful are the ones who can utilize the service properly.

My brother is a top-floor hospital admistrator and he has very few good things to say FWIW

[Mark Howard]

I have it since my GP left his group practice. $1600/yr, no waiting for appointments, text anytime, weekends if I need him, calls in scripts if I need it, takes his time with me, 2 physicals a year (one insurance, one membership) takes my tricare, will assist with wife and kids if traveling or in a bind. I’m healthy and have no issues, but I’ll never, ever go back to the group physician BS. Best healthcare decision I’ve ever made.

[SCadaddle]

I signed up with the local concierge medical outfit a few years ago (5) when I didn't have medical insurance. I paid the first monthly payment of $69 and signed on the bottom line. Moments later my lower lip that was split in half was stitched up at no additional charge. I could have opted out from that point on and it would have been a deal compared to the doc in a box outfits or the ER of a hospital. But I stuck with the Doc because he was a really good fellow that I could trust with my care. Had a doppler ultrasound of my legs done by the local hospital with some kind of voucher he found me for about $200. Most of the meds were either free or very inexpensive.

Until something major like a heart attack happens and you are pretty much screwed.

So I'd say for a family type situation with kids always sick or breaking bones and stuff, yeah, IF you have no medical insurance the concierge for a family might be a deal. Or maybe your health insurance plan has an outrageous deductible. That might be a reason to sign up with one.

[Deschodt]

Define concierge ? I guess I thought I knew but your fees are high. I joined a "group" that charges a yearly fee but it's only $200 or so. One Medical, bay area mostly.

I love it... Also my insurance pays membership on certain plans.

The doc is always on time (the biggie for me, regular GP was always 30-45 late and unapologetic, and 3/4 of the time I'd see a RN). The labs are on site and always available now. Results are super fast. If my doc is busy any member doc of that office can take over and see me that day in that location, or a further location if really busy. No Q asked, they all have your file.

I would NEVER go back to a regular GP, in fact I changed plan to stay with that group. Sadly Amazon has bought them, so we will see what transpires now.

[Deschodt]

I have asnswered my Q : One Medical, the first major low-cost concierge medical group to attempt this model in a large scale, which requests a $199 annual membership fee. So yes I have a concierge doc and I fricking love it.

[fintstone]

My wife has joined a concierge practice for her care. It costs a couple hundred a month. She did so because her family practice doctor changed to this type practice and it was the only way she could stay with him (and she did not want to change). It is more like a "membership charge than anything as it does not reduce any of her costs for care otherwise and insurance will not pay for any of that portion. She has BCBS, Tricare, and Medicare...so over insured already (plus our daughter is a family practice doctor).

So far, there seems no real advantage (other than not having to change doctors). She has appointments as before and they cost the same. He allots a little more time...but she does not need it.

[GH85Carrera]

The medical profession has been turned upside down and I don't want to PARF this thread as to why.

My regular GP is a friend and great doctor I liked. He basically was filling out endless paperwork and at the end of the year, he was making very little money for 12 hour days and on call so often. He finally just found a job at a very large national company based in Oklahoma City, as a company health provider. The employees can use him and he works normal business hours, and just gets a paycheck. He has a staff to fill out the endless paperwork.

I had to find a new internist for my health needs. I too am pretty healthy, and I see him once per year for blood draw and my annual physical. During the worst of the China flu pandemic we did one appointment via facetime, and used a local blood testing facility for the blood draw and he was happy, and so I was I.

The concierge medicine service sounds pretty expensive. Especially for a medicare patient.

[Rick Lee]

A close college friend is a dentist in the Bay Area. She started her own practice about 12 yrs ago and was miserable. She just wanted to be a dentist, not an office manager, do billing, hiring, etc. Last I spoke with her, she was looking into going back to work at someone else's practice and just be a dentist. So I can sympathize with doctors who want to go concierge. They already have the staff to handle all the non-doctor work, but getting paid by insurance X% of what they actually bill doesn't make their overhead go down by that delta. And our healthcare system would be turned upside down if people actually saw what stuff cost beforehand and paid with their own money.