Concierge Medicine

By Alan Terlinsky, MD, FACP

Nu-Living Weight Management

. http://www.nu-living.com

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Concierge Medicine

Concierge medicine is a general term that describes an intensified, patient focused relationship between a doctor, usually a primary care physician, and his/her patient wherein the patient pays an affordable annual membership fee for improved access to the doctor and for high-quality, preventive individualized medical care.

To achieve this, the doctor limits his/her practice to about 500-600 patients, sees a reduced daily patient schedule and provides his/her patients with an enhanced package of personal service benefits. Dr. Howard Moran is credited with inventing concierge medicine in Seattle, Washington in 1996.

Today primary care and internal medicine doctors and patients are expressing great frustration and dissatisfaction with the medical care system as it presently exists. Patients are dismayed by the difficulty in obtaining timely appointments, late starting office visits, unreturned phone calls and impersonal office staff, obstacles in obtaining prescriptions, and inadequate time with the doctor to address health concerns.

Primary care is in dire straits because of inadequate reimbursement from managed care and government programs. Stark economic practice survival compels many hard working and dedicated internal medicine and family physicians to routinely “overbook” daily office schedules resulting in very short 5-7 minute visits for needy complex medical patients. Encounters with the doctor seem rushed and can assume an “assembly line” nature. Patients complain there is an absence of “old-fashioned ” personalized care and feel they are treated coldly like “just another number.”

The situation is made worse by a critical and worsening shortage of primary care doctors. According to the American Association of Medical Colleges, the United States is expected to face a shortage of 124,000-159,000 physicians by 2025.

Concierge medicine has also been referred to as private, personal care medicine, membership medicine, retainer medicine, direct care medicine, boutique medicine, or celebrity medicine.

Some of these titles sound “elitist”, however a membership fee for personalized care in a typical concierge practice is now as affordable as the annual cost of a cell phone, cable TV or a daily premium coffee at Starbucks.

Most concierge medicine physicians accept insurance plans for medical services. The annual fee is not covered by insurance but may be covered by HSA and Flex plans. Advocates of concierge medicine emphasize it is not about “price” but about going back to the “old days” of personalized medical practice when the doctor patient relationship was most important. Medical practices across the country are adopting variations of this new medical practice model in increasing numbers.

In summary, concierge medical care is providing a choice for patients to invest in a unique medical care arrangement with their doctor. Benefits usually include an annual, comprehensive preventative health assessment, risk factor identification, and physician generated wellness and nutrition plans. Thoroughly explained test results are provided. The doctor acts as a health system “quarterback”.

Strategies are developed to prevent avoidable emergency room visits and hospitalization. The patient has impressive access to the doctor including his/her cell and beeper number 24/7 and is encouraged to call if they feel the need. Same day or next day appointments are standard. The office visit now is convenient, unhurried and starts on time lasting as long as necessary.