Have you ever felt that your primary care doctor doesn’t have time to adequately care for you? Or do you feel that he/she doesn’t really know you? Do you hate sitting in waiting rooms while your doctor finishes up with other patients? If so, you are not alone. Primary care doctors are busy! Most primary care doctors have 2,000 – 4,000 patients under their care. As a result, they can struggle to provide patients with adequate attention. Additionally, insurance regulations often force doctors to see patients in time-limited slots of 15-20 which can negatively impact the quality of appointments. All of this can lead to patient dissatisfaction and doctor stress. The answer for many doctors and patients? Reaping the benefits of concierge medicine. (For more information, read Primary Care Physicians are Stressed!)
What exactly is concierge medicine?
To more easily provide patient-centered care and to foster a strong doctor-patient relationship, many primary care doctors are reducing their patient loads to 200 – 1,000 patients. These smaller practices started about 20 years ago and focus on delivering personalized services. Although most of these doctors practice internal medicine or primary care, some specialists have switched to the concierge model. Additionally, some doctors maintain their regular practice, but save a few hours every day for patients who pay an annual fee.
Is direct medicine the same as concierge medicine?
It’s easy to confuse concierge (also referred to as boutique or private) with direct practices (referred to as DPC – direct primary care). Although there are some similarities, there are core differences. Concierge practices charge higher fees, take insurance, and provide unparalleled access to the doctors. Direct practices do not take insurance. Instead, their yearly fees, which are less expensive, generally cover all office visits and lab work. However, patients must pay cash for any services not covered (and patients still need insurance for specialists, hospitals, etc.). Also, direct practices generally do not provide as much access to doctors as concierge practices, although appointments in direct practices may be longer and less rushed than in typical practices. However, each practice sets their own structure and rules, so ask for details if you are considering either type of practice.
Although this post focuses on the benefits of concierge medicine, the chart below illustrates some of the differences between concierge and direct practices:
What are the benefits of concierge medicine?
Concierge practices offer many benefits for their patients. Firstly, your doctor knows you well, and understands your medical conditions, helping you get the best care and outcome possible. Moreover, these doctors will provide you with a level of attention that is impossible for doctors in standard practices. The low volume of patients seen every day allows these doctors to focus more time on each patient, both in the office and via email and phone. How big is the difference in workload? Huge!
- Concierge doctors may see as few as 5-10 patients/day
- Standard practice doctors usually see 24-25 patients/day
What are the perks in concierge practices?
The benefits of concierge medicine would be appreciated by most, if not all, patients. Although every practice sets their own rules, many offer the following perks:
- Unlimited office visits.
- Extended, longer office visits.
- Easier scheduling of appointments, often including same-day appointments.
- Less waiting time at the doctor’s office:
- 33% of concierge practices claim patients NEVER wait.
- 32% of concierge practices state patients wait less than 5 minutes.
- 24/7 immediate (or close to immediate) access to the doctor via phone, text or email.
- Easy renewal of prescriptions.
- Home visits.
- Wellness services, such as extensive annual checkups.
How much does it cost?
Patients pay an annual fee which gives them access to personalized, enhanced services generally not available or covered by insurers. Because each doctor determines his/her own guidelines, services offered, and pricing structures vary from practice to practice.
Generally, concierge practices charge patients an annual fee, usually between $1,200 – $3,000, although some charge $10,000/year or more.
What about health insurance?
Most concierge practices bill insurance for appointments (co-pays and deductibles apply), although many include an extensive annual exam as part of their yearly membership fee. However, not all concierge practices take Medicare and/or insurance, leaving patients responsible for expenses not covered by the annual fee. Either way, patients need health insurance for specialists, hospital stays, testing, ER visits, surgery and any other services not covered by the concierge plan.
How popular are concierge practices?
According to the Concierge Medicine Today, it is very hard to know exactly how many doctors use this model because there is no national database or registry. However, Concierge Medicine Today estimates there are probably between 5,000 to 20,000 private (concierge) doctors in the US (out of a total of more than 923,000 practicing licensed doctors in the US).
The pros and cons of concierge care.
The pros are obvious:
A doctor with a patient load of 200 – 1,000 will have more time for their patients than those managing more than 2,000 – 4,000 patients. Concierge patients receive personalized, patient-centered care, with less hassles around making and attending appointments. These practices are of particular benefit to patients who are elderly and/or managing chronic conditions.
The cons are financial:
Membership in a concierge practice is expensive. And you still need to pay for health insurance premiums, co-pays and deductibles. Certainly, this is financially impossible for many patients.
Thinking about enrolling in a concierge practice?
Before you sign on the dotted line, be sure to do your homework. First of all, get detailed information on how much they charge along with a detailed list of what the fee includes. Importantly, take the same steps you would take when considering any new doctor. And, it’s always a good idea to speak with other patients in any practice you are considering. For more information on how to select a new doctor, read How Do You Find a New Doctor You Can Trust? And, visit Zaggo’s resource page for sites you can use to evaluate doctors.
Where can you find a concierge practice?
Ask your friends, family, and colleagues if they, or anyone they know, use a concierge practice. If you can’t find a doctor through your personal channels, you can find a list of concierge practices with the Concierge Medicine Today Doc Finder.
Across the board, doctors face mounting pressures. To learn how this can impact you, read Doctor Burnout Can Impact Your Health.
Additionally, no matter which type of medical practice you use, being engaged in the process will help you get the best care and outcome possible. Read these posts for more information:
- Understanding Medical Information Is Harder Than Most Realize.
- 10 Tips for a Better Medical Appointment.
- Why Take Detailed Notes at Doctor Appointments?
- Should You Record Conversations with Your Doctors During Your Medical Appointments?
- Being an Engaged Patient Can Help You Get the Best Medical Care Possible
- 10 Tips to Communicate Better with Doctors.
- 6 Tips to Better Manage Your Care.