This is the 3rd post of my 4-part series on new trends in healthcare. Today’s post focuses on concierge doctors and smart hospitals.
To read the other posts in this series:
- Telehealth and medical scribes
- Uber vs ambulances, EMT care in your home and tablets for hospital patients
- Personal tracking devices and digital pills
More Doctors Adopting Concierge Care Models
Most primary care doctors have 2,000 – 4,000 patients under their care. This high case load can make it hard for patients to be seen in a timely manner. Additionally, insurance regulations often force doctors to see patients in time-limited slots of 15-20 minutes/patient, which can negatively impact the quality of appointments. All of this adds to doctor stress and patient dissatisfaction. Conversely, doctors with smaller case loads are likely to be less stressed and burned out (an increasingly common problem), which can provide better experiences for all.
What exactly is direct, boutique, private or concierge care?
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 practices, referred to as “direct”, “boutique”, “private” or “concierge”, started about 20 years ago and are focused on delivering personalized services. Most concierge doctors practice internal medicine or primary care, but there are some specialists who have switched to the concierge model.
Patients pay an annual fee which gives them access to personalized, enhanced services generally not available or covered by insurers. Each doctor determines his/her own guidelines so services offered and prices vary from practice to practice.
What services are offered to patients?
Enhanced services available may include:
- Unlimited office visits
- Extended, longer office visits
- Easier scheduling of appointments, often including same-day appointments
- Less waiting time at doctor’s office
- 33% of concierge practices claim patients NEVER wait
- 32% of concierge practices state patients wait less than 5 minutes
- Immediate access to the doctor via phone, text or email
- Easy renewal of prescriptions
- Home visits
- Wellness services such as annual checkups.
How much does a concierge or boutique practice cost patients?
Since each doctor can set his/her own structure, the costs, services and guidelines vary greatly.
Concierge practices charge patients an annual fee, generally between $1,200 – $3,000, although some fees can be as high as $10,000.
In some practices, patients pay for each office visit in addition to the annual fee. In other practices, the yearly fee covers all in-office care. About 1/3 of practices take Medicare and/or insurance. Some doctors maintain their regular practice, but save a few hours every day for patients who pay an annual fee.
How many doctors have 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).
That number is likely going to grow in the next few years. The 2014 Survey of America’s Physicians showed that a huge percentage of doctors are planning to pursue the concierge model. Some of the survey’s key findings:
- 7% of doctors report they are already practicing concierge medicine.
- >13% of doctors plan to transition to concierge medicine at some point.
- Doctors aged 45 or younger are more likely to consider concierge practice.
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 patients. You will be getting 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:
No matter how much you pay in annual fees, which are NOT covered by Medicare or insurance, you still need health insurance. This is true even for primary care practices that includes the cost of in-office visits in their annual fee. You still need insurance for specialists, ER visits, hospitalizations, testing, medications, surgeries, etc.
Thinking about enrolling in a concierge practice?
Before you sign on the dotted line, be sure to do your homework. Get a detailed list of what the fees are, what is included for your annual fee, what you will have to pay for in cash, and what services the doctor will provide. It’s always a good idea to speak with other patients in the practice you are considering, and to take the same steps you would take when considering any new doctor. See Zaggo’s resource page for sites you can use to evaluate doctors.
More “Smart” Hospitals
Technology is rapidly improving in all areas, including hospitals. Most US hospitals use a lot of digital technologies, but far fewer qualify as “smart hospitals”.
What’s a smart hospital?
The definition of the term smart hospital can vary. A recent report by Frost & Sullivan on smart hospitals included a definition that helps us understand the concept: “Smart hospitals optimize, redesign, or build new clinical processes, management systems and potentially infrastructure, enabled by underlying digitized networking of interconnected assets, to provide a valuable service or insight, which was not possible or available earlier, to achieve better patient care, experience, and operational efficiency.”
Where is the technology applied?
Smart hospitals have invested, or will invest, in the following areas:
- Cloud computing
- Data analytics
- Remote patient monitoring
- Hygiene management
- Pharmacy automation
- Patient flow solutions
- Secure communications
- Mobile asset tracking
- Smart rooms
Why are hospitals investing in these changes?
These technologies will allow hospitals to improve the patient experience, improve the quality of patient care, reduce medical errors and reduce costs.
How will this impact you?
It’s clearly great that improvements to technology will make hospitals safer and improve patient care. But as with all technological advances, expect some bumps in the road along the way.