women 4 hope

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Royal Pains and Concierge Medicine

Posted by Catherine Morgan on June 26, 2009

Royal Pains: Can Concierge Medicine Coexist With Obama’s Healthcare Plan?

Have you seen the new show Royal Pains?  If so, you are probably now familiar with what a concierge doctor is.  It’s not a bad show, but is concierge (or boutique) healthcare bad for patients?

This is from an episode of The Doctors

Have you ever wished you had your own personal doctor at your beck and call? Now you can. Concierge doctors are gaining popularity, but can the average person afford them? President of Elite Personal Physician Services, Dr. Cheryl BryantBruce, explains that her clients have 24/ 7 direct access to her.

“Whether you get the $100,000 package or the $10,000 package, you will get the same medical care,” Dr. BryantBruce assures. “We have a Hippocratic oath that tells us that is what we are supposed to do.”

It seems to me that if you can afford it, it’s a great way to go.  The trouble is, most people probably can’t afford it.

From Womanist Musings – The Terrible Nightmare of Single Payer Healthcare

The United States has some of the world’s best hospitals, yet millions of U.S. citizens are unable to access their services, making their existence meaningless to large sections of the population. Many die each year due to a lack of insurance and the greatest cause of bankruptcy is unpaid medical bills. Looking from the outside, it is clear that the American Health care system is about profit, whereas the value of a single human life is priceless.

From Doc Gurley

For those of us who don’t live in the rarefied world of “concierge” anything, here’s how a concierge doc works: you, as a doc, sign up people for a fixed monthly amount, then you offer them hand-held service for that monthly payment. Also part of the arrangement is a (sometimes explicit, sometimes assumed) limit on the total number of patients the doc will see – say, 600 people total.

But it’s not just about more and more physicians turning to concierge medicine, it’s about why?

From Chelsey Ledue at Healthcare Finance News

To adapt to market pressures, some physicians are moving to full concierge practices. The model works well for physicians – and for patients who can afford it – but it often disenfranchises those patients who can’t afford or don’t want to move to such a model.

“The way the market is moving we may well create a system where millions of Americans no longer have access to primary care physicians,” said Lipton. “This creates a bit of a paradox as the administration and healthcare leaders are publicly highlighting what an important role PCPs play in providing and coordinating care for Americans.”

From Jennifer Erickson of The Laguna Beach Independent

Some opponents of concierge medicine view the business model as an extra level of bureaucracy atop managed care medical insurance. Dr. Bill Anderson, who runs the Sleepy Hollow urgent care facility downtown, wrote recently in a weekly ad, “if you have a real doctor in a private practice and not a managed care medical plan, you get the same service, minus the frills. Your doctor or an associate is available by phone 24/7 and they coordinate emergency and hospital care when you need it. So what’s the big deal?”

Will concierge medicine help or hurt the millions of uninsured and under-insured in our country?

From Josie Brown at Single Minded Woman – Support Single Payer Healthcare

Last week I got a notice from our insurance carrier that our family policy rate was going up — almost 35% (!!!) — oh, and yeah, it’s time for my college age daughter to get a plan of her own: another $159 above and beyond the increase.

Few kids in college can afford to cover their own health insurance policy. Of course Martin and I will do so until she’s making an income that will do so (forget about a plan from an employer: those are becoming as rare as Ugg boots).

Adding to our cost concerns, our deductible is being raised again, and some benefits (I use that term lightly) are no longer included.

How will this new form of healthcare integrate itself into the Obama healthcare plan?  Does it even want to?

From Mommy Life – Obama and ABC Merge

On the night of June 24, the media and government become one, when ABC turns its programming over to President Obama and White House officials to push government run health care — a move that has ignited an ethical firestorm!

Highlights on the agenda:

ABCNEWS anchor Charlie Gibson will deliver WORLD NEWS from the Blue Room of the White House.

The network plans a primetime special — ‘Prescription for America’ — originating from the East Room, exclude opposing voices on the debate.

Have you checked out the new show Royal Pains?

From Megan’s Minute – The “Royal Pains” of the Hamptons

Did you know there were such things as concierge doctors?

Medical professionals who hang out at ritzy resorts waiting for party-goers to overdose, or slip on the dance floor or crack-up their cars? That’s when a discreet doctor is literally worth his weight in gold.

So…What do you think about concierge medicine?  Will it help or hurt our chances of getting quality and affordable healthcare for everyone?  If you had the money would you prefer to have a concierge doctor?  Let me know your thoughts in comments.

Contributing Editor Catherine Morgan
at Catherine-Morgan.com and Women4Hope

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5 Responses to “Royal Pains and Concierge Medicine”

  1. pp said

    The healthcare system is a mess. If you look at what the trends are for all the players in healthcare.

    View for Primary Care Physicians
    —————————
    you will see that primary care physicians are either quitting and going into subspecialties, moving to another state which either pays better or has lower malpractice premiums or moving into concierge medicine. Insurance companies continue to push payments lower and increase documentation and billing hassles, malpractice companies keep increasing premiums ($30,000 – $40,000 for an internist/family physician in NY), government keeps adding more requirements. Many have not been able to give raises to their staffs in years and also no longer provide health coverage to their staffs.

    View for Patients
    ————————–
    Patients are seeing that their premiums are going up and their coverage is getting skimpier or losing coverage in total. The premiums now cost between $1000 and $1500 a month for a family plan. This is as much or more than the monthly rent. These costs being quoted are for the healthy families that go zero to one time a year to see a physician.

    View for Specialists
    ————————-
    This view is only for certain specialties only. Those specialties which have sophisticated diagnostic and operational procedures. There are many other specialties which don’t have too many procedures who’s view is similar to the primary care physicians above. For the procedural specialties (such as Cardiology, orthopedists..) they have made and continue to make above $300k upto a couple of million. They want to keep their lifestyle and pay which the AMA is happy to oblige with at the expense of the non-proceduralists and primary care. They want to keep the status quo.

    View for Insurance Companies
    —————————–
    There has been less and less competition as the health insurers merge or take each other over. The CEOs and other officers are making hundreds of millions of dollars (United Health Care ex CEO was compensated about a billion dollars). They don’t mind spending a few hundred million to a few billion in aggregate to pay off their friends in washington to keep the status quo. They also don’t really fight to keep costs down since their profits are measured in percentage of health care dollars spent. That means that they make more money if the health care costs are 2 trillion than if the health care costs are 1 trillion. The percentages they have been making have gone up from 5% from the early eighties to about 35% currently (some plans with their cherry picking of healthy patients only are making closer to 66%).

    View for Pharmaceuticals
    ———————–
    The united states is great. They fund research into drugs with investmetns of 10 to 100 million and get returns of 1 to 2 billion a year. They can charge $5 a pill in the U.S. wheras when they sell the same medicine in Canada or Singapore they get paid $1 a pill. They also have excess funds to pay their friends in washington to make sure that the laws are written in ways to benefit them. They want to keep the status quo.

    Governement Officials
    ———————-
    There are all kinds views but the end results have been consistent. Laws passed that keep expanding requirements for more coverage from insurance companies (drug plans added to medicare, chiropractor coverage added, nutritionist coverage added, mental health coverage added…). The insurance companies then raise the premiums on everybody just in case a very small number may use the coverage. They keep raising the requirements of what medical physicians and facilities must do. This raises quality but it is difficult for medical providers since their reimbursments at the same time keep going down. Their are a fair number who get very nice things (value in the hundreds of thousands) from their friends at the drug and insurance companies.

    The trends are:

    Primary care physicians are going out of business trying to provide care in the way they were trained. Those that remain are decreasing time with patients and are looking to add more procedures such as laser hair removal. Most primary care physicians would be happy to provide their services for $75 to $125 for a real visit (ie take the actual time needed to address your problems) if there was no insurance hassles. Patients for the most part would also not be opposed to paying near that range. However insurance companies are holding the physicians to $40 in NY (this year some plans are trying to push further down into the $30s).

    Increasingly physicians are choosing the private payment model and becoming concierge. Many in primary care are seeing this as the only solution since patients are disgruntled with their premium payments but are not getting great service since the insurance company is in the middle. Health insurance will become insurance again, that is, it will be used only when their are catastrophic events and not used for regular visits and wellness. We are seeing this trend with the High Deductible savings plans (the only problem there is that the insurance companies have still not priced the HSA low enough to reflect the less exposure they have).

    This is where we are in healthcare today. When Obama pushes through healthcare reform this year alot of things will change. I originally thought he would make things better but as I see him watering things down due to pressure from insurance company, drug companies and trial lawyers I fear that he is only going to make things worse.

    • DR. K said

      I like this post. As a physician I am incredibily disgruntled with the health insurance industry. The premiums continue to rise, doctors continue to have to spend enormous amounts of money for staff or a billing service to argue with insurance companies to get paid. This delay alone can take 30-90-over a year for the doctor to get paid. Prime example, as a medicare provider, Medicare has held my reimbursement for over a year we are talking large amounts of money that they will pay (which really is only about 30% of the total bill), and then, they will only DIRECT deposit into my account. How many of you like to give the government your bank account information with carte blanch to pull money out if they feel they overpaid. Problem is, they have held it because they state, “We have 13 other providers infront of you having their information added, this could take up to 90 days to change that information”. REALLY??? only 13 with a routing number and an account number to add, what would this take in normal society, 15 minutes to fix? Believe me, Medicare isn’t the only one, they are all bad and coming up with terrible excuses for not paying.

      People, if you only understood what goes on when you come to the doctors office. We see you (staff first then the doctor, then you see staff again, other staff then bills and follows up for months). This costs ultimately a lot of money and no one can understand why doctors fees (family, internist, chiropractors etc) are going up. The problem isn’t the doctor or his/her office, it is the insurance company. These companies have become for profit which GREAT profit margins and large paid out dividends. They take from you the consumer, pay out small amounts and pay the executives big money. How is this fair to anyone.

      Insurance companies should be Non-Profit!!! If President Obama could understand this and fix this, there would be NO need for nationalized healthcare, which does not work. Everyone will be waiting for their care and getting very little at the end of the day. Look at Canada etc…

      Maybe concierge is the way to be, I have watched Royal Pains, not a bad gig if you ask me. All you need is a great bedside manner and a great set of skills and away you can run. By the way, there are so many doctors today with such terrible bedside manners. What’s going on?

  2. rocky said

    this is a nice post

  3. Great article. Keep posting more info about this subject.

    Steven T.

  4. Michael said

    There is a “brand-new” Concierge Medicine News source, Concierge Medicine Today. You should check them out at: http://www.ConciergeMedicineToday.com. Tons of educational information, research, news, legal updates, insurance information, etc.

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