Our long time GP now limiting his practice

[Free]

Our long term GP is limiting his practice to those who pay an annual fee of about $2000 each. He's been our primary physician for about 25 years. He's become a good friend and we have really enjoyed having him as our doctor. He's finding it increasingly difficult to make it as an independent physician in the past 2-3 years largely due to complex changes in insurance paperwork - he's told me for every 15 minutes he spends with a patient, he spends 20-30 minutes on paperwork.

We don't want to lose him, but my wife and I are healthy and only average 2-3 visits a year (including an annual physical). We have good retiree insurance until after we start medicare. We could afford the fees, but we'd have to cut back in other areas.

Any thoughts or experiences would be appreciated.

 

[REWahoo]

"Concierge medicine" is a widespread movement for private practitioners - but not always successful for the physician.

DW's long time doctor announced she was going this route but it turns out not enough of her patients agreed to make the move with her. She ended up backing out on the plan but by then many of her patients had found other doctors and moved on. Turned out to be a financial disaster for her.

 

[Sojourner]

Same situation with my doctor several years ago. He sent a long letter to all his patients explaining his move to a concierge model and the fees that would be required, and then... nothing ever changed. I still go in once or twice a year on average, and he still sees me just like always even though I never paid any fees. So I'd suggest just standing pat and see how the situation develops before shopping for a new doctor.

 

[ExFlyBoy5]

Same thing happened to our last GP. The marketing he did (it is a franchise operation of some sort) got to be down right annoying. We often only saw his PA, so we moved on. Now, we have a GP that is AWESOME and for all 6 visits (DW and me combined), we have always seen her...not a PA.

Some people have good experiences, but my insurance is very cheap, and the service I get has been pretty damn good so no reason to go this route. Yet.

 

[athena53]

If I had chronic conditions I had to manage, I'd go for it. I really hate what medicine has become now, where you're left sitting in the exam room in a backless garment waiting for the doctor and it's 30 minutes (or more) past your "appointment" time and the doc spends 7 minutes with you before rushing to the next cube. Fortunately, my interactions with doctors are mostly limited to annual exams so I put up with it. I can see how concierge medicine would be great for doctors and for the patients who need it.


I think the doctors who choose this model, though, need to realize they won't get patients like me. They'll get patients who need a lot more attention.

 

[REWahoo]

I can see how concierge medicine would be great for doctors and for the patients who need it.

+1

We have good friends who decided to go the concierge route after he had a mild stroke a couple of years ago. He had a medical problem a few months ago and his doctor went above and beyond to notify the emergency room he was coming in plus helped them cut through a bunch of red tape to get him admitted to the hospital.

Could definitely be worth it if you have health issues, probably not if you don't.

 

[MichaelB]

GPs are in a tough spot. Even though health care costs have risen sharply over the past decades, their share has fallen and specialist physicians have grabbed the lions share of the health care dollar. Insurance companies should help shift some of that money back to the GP, where it probably would have a bigger positive impact on people's health and help contain overall costs. Expecting patients to pay even more may work for a lucky few but will not work in the mainstream.

 

[bclover]

I'd find another GP. I'm pretty much in the same boat. outside of bad knees which I go to an orthopedic specialist, I see the doctor once or twice a year. that includes having the annual women's test.

I'm lucky I live in a large city and most major hospitals have "womens health centers".
I go to the same certified nurse practitioner.

 

[Sunset]

GPs are in a tough spot. Even though health care costs have risen sharply over the past decades, their share has fallen and specialist physicians have grabbed the lions share of the health care dollar. Insurance companies should help shift some of that money back to the GP, where it probably would have a bigger positive impact on people's health and help contain overall costs. Expecting patients to pay even more may work for a lucky few but will not work in the mainstream.

Unfortunately, I believe Ins Companies will increasingly shift the income to their executives (CEO) instead.

"Modern Healthcare's early look at executive compensation included more than 100 companies that disclosed CEO compensation as of April 10. The analysis, which looked across four healthcare sectors, found the five highest-paid CEOs in each sector enjoyed a median increase in total compensation last year of 8.5%. That's a more robust gain than the 4% median growth in net income for the 20 companies headed by these CEOs. Median total compensation in 2014 for the 117 CEOs for whom Modern Healthcare collected compensation data was $5.4 million, with a median increase of 9.6% over the prior year. "

 

[Texas Proud]

I had a sister who had a long term doc who went this way.... IIRC it was $2500 or even $3000... her DH was alive at the time and he went to docs more than her... he decided to move on...

She now has new docs and loves them... good docs are out there and you might find out that another is a better fit for you...


Now, the good thing about this is that you will get an appointment... you do not have to deal with the PA as much and the waiting times are probably less since I do not think they schedule as many patients in a day... at least that was some of the selling points my sisters doc used...

 

[txtig]

My doc went down this road a couple of years ago. $1800 per year. I decided to stay and they charge my credit card 1/2 of the fee every six months. His practice is 100% concierge now.

Prior to the switch, I was typically waiting 45 minutes to an hour each visit. Now, the wait is never more than 5 minutes. The fee includes one very detailed physical a year with extensive lab work. Not all of the labs are covered by my insurance, but he doesn't charge me for the shortfall. Spends about an hour with me for each annual physical. I've had a couple of follow ups since my annual and he spent about 30 minutes each time.

I've got his personal cell phone number if I need to get in touch on an emergency basis. Haven't needed it yet. Thank goodness.


I've had some blood pressure issues over the past 5 years or so, which is pretty well under control now. Bottom line is that I think it's money well spent in my case. DW is actually considering switching to him, since she's had some recent health issues that are going to require close management too.

 

[marko]

My GP did this two years ago and couldn't be happier, nor could I. I pay him a set amount each year, he doesn't take or bill insurance and usually will see me within an hour. He's done so well that he's taken on an additional MD to his group.

This is a little different from concierge care...it's called direct care; you pay a fixed fee and get X number of visits, blood tests, and physicals.

Again, he does not involve insurance so his costs are minuscule and only needs a receptionist/office manager instead of paying 7 or 8 people to chase insurance.

 

[meierlde]

Our long term GP is limiting his practice to those who pay an annual fee of about $2000 each. He's been our primary physician for about 25 years. He's become a good friend and we have really enjoyed having him as our doctor. He's finding it increasingly difficult to make it as an independent physician in the past 2-3 years largely due to complex changes in insurance paperwork - he's told me for every 15 minutes he spends with a patient, he spends 20-30 minutes on paperwork.

We don't want to lose him, but my wife and I are healthy and only average 2-3 visits a year (including an annual physical). We have good retiree insurance until after we start medicare. We could afford the fees, but we'd have to cut back in other areas.

Any thoughts or experiences would be appreciated.

You say he has been in practice for over 25 years. Is this a way of semi retiring to a lower workload?

 

[LOL!]

My previous physician did the same thing. I just switched to another physician. Guess what? No big deal.

I'll add that in my younger days I worked in a hospital. I learned then that physicians usually do not deserve the respect most people give them. Sorry, but that's my experience with many many physicians ... even the good ones.

So I don't put doctors up on a pedestal. And that goes for my friends, family, and neighbors who are physicians.

So if you hate switching doctors, then find a new younger one who can care for you until you die.

 

[marko]

You say he has been in practice for over 25 years. Is this a way of semi retiring to a lower workload?

My guy lowered his patient load from 2500 to a max of 650.
He went this route because he was frustrated with insurance only allowing him limited time with patients and he didn't really feel he was helping people.

He can now spend a long as he needs to treat me (vs insurance required 15 minutes) and can take the time to really get to the bottom of issues. On one visit, he spent just over 45 minutes with me.

He also has a young family and can now spend more time with them.

 

[jim584672]

To me this sounds like a scam, a way to empty wallets of people with too much money.

 

[marko]

To me this sounds like a scam, a way to empty wallets of people with too much money.

I get to spend as much time as necessary with my doctor.
I get to see him within the hour that I call for an appointment (most often).
I don't have to wait 40 minutes (late!) in the waiting room for him to see me.
He's available via email and Skype for general or specific questions--I talk to him directly, not a nurse who relays back and forth all day.

It costs me less than half of what I spend on boat maintenance per year.

Some might view it a scam. I see it as the future of health care.

If I'm among the "people with too much money", well..........I can't do anything about that.

 

[LOL!]

@marko, many non-concierge doctors provide all those features nowadays. They know that folks have a choice of doctors, so service is important.

 

[athena53]

To me this sounds like a scam, a way to empty wallets of people with too much money.

Nope. In my view it adds another tier to the healthcare system. There will always be pressure- from insurers, regulators, consumers, Medicare, etc.- to keep costs/fees low. There will always be a group of providers who are so valued for the quality of their care that they can charge extra and there will be people willing to pay it.

 

[razztazz]

To me this sounds like a scam, a way to empty wallets of people with too much money.

No matter what else good and bad comes from the arrangement, yes , it is also this. It's business. Get the money. Skirt the goods and services

 

[marko]

@marko, many non-concierge doctors provide all those features nowadays. They know that folks have a choice of doctors, so service is important.

I'd be surprised if an insurance charging, non-concierge doctor could spend 30 or 45 minutes with a patient; at least not in these parts. My experience with the same GP two years ago when he was on the insurance treadmill was 15 minutes.

Then again, as noted, maybe I just have too much money.

 

[Ally]

My doctor did that two years ago. I signed up for her concierge practice and was very happy. However, she closed her practice and is moving to a another area of TX. I think she is looking towards retirement in a short time. She said she got an offer to practice concierge with a group.

I was disappointed, but found a wonderful young internist. I like her very much and I don't have to pay extra.


Sent from my iPhone using Early Retirement Forum

 

[RobbieB]

My guy is retiring June of next year. Good for him.

Bad for me. I like that guy, he is good with a knife.

 

[Bamaman]

Most of our local physicians practices have been bought out by the hospitals, and the office personnel belong to them. The doctors remain in the practice as independent contractors.

In Tennessee, Central KY and SW VA, Vanderbilt Hospital has 1700 doctors and physicians assistants in their affilitated clinics. And they refuse to take Medicare Advantage plans due to low pay schedules. They do take regular Medicare with a supplement.

My local doctor refuses to see any Medicaid patients, and he only sees Medicare patients that have a supplement. And he's an unhappy camper--forced to go to computer records linked into government and insurance company computers. He spends his days fighting insurance companies and the government who won't allow him to treat patients as they need treating.

It's a shame that physicians have never been successful enough in their retirement accounts and investments to have $5 million in their retirement accounts. With 2.3 children, the big house, 3 luxury cars and kids in private universities, they're having to work into their 70's.

 

[Walt34]

I'd be surprised if an insurance charging, non-concierge doctor could spend 30 or 45 minutes with a patient; at least not in these parts. My experience with the same GP two years ago when he was on the insurance treadmill was 15 minutes.

I guess it depends on the physician and/or the area. My doctor spent a good 45 minutes with me just a couple of weeks ago. Granted most visits are on the order of 10-15 minutes but that's all that was needed. I have never sensed that he was rushing things to get on to the next patient.

But WV isn't exactly a high COL area so he probably doesn't have the financial pressures that many docs do. BTW, he's a candidate for this forum - his car is 18 years old.