Our doctor is going concierge....

[Dixie19]

One thing I'll add about my semi-concierge doc, is that they respond super quickly to email, often with a phone call. They are pretty easy about calling in prescriptions without making patients come in to the office too.

 

[psweath]

I go to a concierge physician because of lots of the reasons mentioned above. The main reason though is that he is focused on prevention, and not just diagnose and treat, disease management.

 

[donheff]

That's the story which has yet to be told. Patient compliance and interest in these "concierge benefits" will probably wane, IMHO. Prior patients will drift off to other PCPs and will be reluctant to go back to their original doctor in some cases.

Some doctors will make it and some won't. By then Obamacare will have converted large numbers of previously uninsured patients to insured ones. This is a delicate situation which I am glad I am watching from the sidelines.

When asked, I usually advise staying with the original PCP for about a year and see if you are getting your $2,000 worth. There are a lot of moving parts here.

When in private practice decades ago, it evolved in to a concierge-like practice due to a wealthy demographic. I was much happier with my subsequent university teaching practice: diverse, Joe six-pack followed by rocket science types, lots of fun and great quality of care.

+1

Only a limited number of doctors will be able to successfully make a switch to concierge. They need patients and most won't be willing to cough up the extra bucks. Many years back, DW dragged us off to a concierge doctor when our primary care doc's practice was bought up and the new office staff were terrible. The concierge guy had great staff and was a chatty Cathy but after a few years we did the math and decided to go back to our more convenient neighborhood practice. The staff is marginally improved but still a PITA. But the docs we see seem to provide the same guidance, albeit with a bit less talk.

Now we have a new option a block away - a walk in clinic for urgent but non-emergency care. DW went over for a foot problem when the wait for the regular docs seemed excessive. The urgent care joint was quick and efficient. They use nurses for a lot of services but what the heck, that is often all you need and a nice supplement to Dr Google, who can't prescribe meds.

 

[photoguy]

Is this trend for concierge physicians primarily for general practitioners (as opposed to specialists)? The last time we needed to see a GP was for my citizenship physical many years ago. We always try go straight to a specialist -- if we're forced to see a GP it ends up being a waste of time as they will just refer us to the specialist that we knew we needed to see anyway.

 

[braumeister]

We always try go straight to a specialist -- if we're forced to see a GP it ends up being a waste of time as they will just refer us to the specialist that we knew we needed to see anyway.

If that works for you, you're golden. But I generally have no idea who a good specialist would be, and the referrals my PCP has given me over the years have always turned out to be outstanding. So that's a big factor for me.

 

[Ally]

I go to a concierge physician because of lots of the reasons mentioned above. The main reason though is that he is focused on prevention, and not just diagnose and treat, disease management.

Some of the reasons we are considering staying with our doctor and paying is that she focuses on prevention, she encourages us to email her (in fact I did that yesterday to have a problem with the pharmacy straightened out) and she gave me her cell phone # years ago. Plus she understands and manages our conditions that can go out of control if not monitored (kidney disease, auto immune disease, high triglycerides, pre-diabetes, asthma, and some more issues.) We have both become much more healthy with monitoring, education and prevention. I think she wants to practice this type of medicine, but is feeling the big squeeze from the insurance companies and the corporation she works under. She said they want her to keep her visits to 5-6 minutes and she said she can't. She said she moved here from Canada 20 years ago to get away from govt. controlling medicine. Anyway, it sounds like for us it may be worth trying it.

 

[haha]

Does a doctor need to abandon Medicare if he charges a concierge fee?

Ha

 

[MichaelB]

Does a doctor need to abandon Medicare if he charges a concierge fee?

Ha

I checked the Medicare database and a local group of concierge doctors have considerable Medicare billing. It appears that as long as they take Medicare assignment for any treatment or procedure they are free to charge a membership fee.

 

[ERhoosier]

I checked the Medicare database and a local group of concierge doctors have considerable Medicare billing. It appears that as long as they take Medicare assignment for any treatment or procedure they are free to charge a membership fee.

Many "concierge" docs also seem to have some non-concierge patients. PCP's may keep at least some established patients as they age into Medicare system. Does not mean they are paying concierge fees. These patients could be handled under usu Medicare billing procedures.
HHS OIG tells docs that charging concierge fees to Medicare patients for covered services is an illegal practice.

"You may see advertisements offering to help you convert your practice into a "boutique," "concierge," or "retainer" practice. ... If you are a participating or non-participating physician, you may not ask Medicare patients to pay a second time for services for which Medicare has already paid. It is legal to charge patients for services that are not covered by Medicare. However, charging an "access fee" or "administrative fee" that simply allows them to obtain Medicare-covered services from your practice constitutes double billing."
I. Physician Relationships With Payers | Physician Roadmap | Compliance | Office of Inspector General | U.S. Department of Health and Human Services

 

[MichaelB]

Doctors that have concierge practices can take assignment from Medicare, they just need to be careful not to violate Medicare regs, particularly not charging for something already covered by Medicare. Here's a reference that gives a high level overview. http://www.tha.org/HealthCareProvid...HealthLawC08AE/ConciergeMedicine_ Hilgers.ppt

Concierge Medicine: Key Legal Considerations

Complying with Medicare Regulations, Insurance Laws and the Anti-Kickback Statute

Texas Health Law Conference. October 15, 2012