| The last time you called your doctor's office, how | | | | physician day or night, house calls if necessary, |
| long did you have to wait for a reply? How long | | | | continuing care if hospitalized, complete physical |
| do you usually have to wait to get an | | | | examinations, audiometry screening, cardiovascular |
| appointment or wait for a prescription to be called | | | | and cancer risk screening, more attention to |
| in? When you get to the office, how long do you | | | | preventive care, unrushed appointments, all |
| spend in the waiting room and how much time | | | | questions answered, family meetings if needed, |
| does the doctor spend with you? | | | | coordination of care with specialists, provision of |
| Did you get all your questions answered? How | | | | personal health records on CDs or flash drives, |
| many seconds do you have in the beginning of | | | | etc., etc. |
| your appointment to explain your symptoms | | | | Depending on the type and number of services |
| before you are interrupted? Do the nurses and | | | | that are provided, the flat retainer fee can vary |
| doctors seem to be more interested in their | | | | widely from one area to the next ranging from |
| computers or their charts than they are to you? | | | | $100 to $20,000/ year, most probably averaging |
| If your experiences are like most people, your | | | | around $1500-3000/year. There were only a few |
| answers to these questions are not very | | | | hundred of these physicians a few years ago, but |
| flattering to the medical profession and to the | | | | there are over 5000 of them now all over the |
| health care system in general. Most doctors don't | | | | country. Many of them, but not all, are listed at |
| really want their practices to be like this, but they | | | | the main website for the Society for Innovative |
| don't have much choice. They have to have a | | | | Medical Practice Design - Patients may be able to |
| high volume of patients in order to make ends | | | | find a concierge physician in their area on this site. |
| meet financially. The high volume makes the clinic | | | | There has been some controversy surrounding |
| a very busy place and most patients don't feel | | | | some of these practices because some |
| like they get much attention. | | | | authorities feel the growth of concierge medicine |
| In 1996 in Seattle, a doctor named Howard Moran | | | | will lead to a 2-tiered medical system in this |
| thought there should be a better way to do this. | | | | country - one for the wealthy and one for the |
| He pioneered the concept of having a lower | | | | not-so-wealthy. Also, with the current shortage of |
| volume practice with highly attentive medical care | | | | primary care physicians (PCPs), with increasing |
| provided as a service for patients in return for a | | | | numbers of concierge practices, the number of |
| retainer fee, much like many attorneys or | | | | PCPs available for traditional offices will be even |
| accountants use. This fee may be in addition to, | | | | smaller, and access to care for patients served |
| or in lieu of, the regular office fees that are billed | | | | by those practices will suffer. On the other hand, |
| to insurance companies. This concept allows the | | | | more medical students may become interested in |
| practice to remain financially solvent while | | | | primary care if opportunities in concierge medicine |
| providing better, more attentive medical service | | | | are available to them when they finish their |
| to its low volume of patients (usually keeping the | | | | residencies. |
| patient count down to about one tenth of the | | | | Some of these practices have come under fire |
| number in a typical traditional primary care | | | | from insurance companies who say that concierge |
| practice). | | | | physicians are basically providing an insurance plan |
| Unfortunately, health insurance companies | | | | for their patients without having an insurance |
| currently don't pay for this type of service, so | | | | license to do so. The practices must therefore be |
| that means the patients have to pay this out of | | | | legally and financially structured in such a way that |
| pocket, but if the service is good, it may be | | | | avoids this criticism. |
| worth it. Patients who join these practices are | | | | Overall, the concept of concierge medicine |
| encouraged to keep their usual insurance which | | | | provides a good alternative to the currently |
| they will need for visits to other specialists, | | | | unsatisfying traditional model of medical practice. |
| laboratory testing, radiological testing and/or | | | | The fee may seem high to some, but in most |
| hospital services if needed. | | | | instances, it probably isn't much higher than the |
| Many concierge practices offer same or next day | | | | cost of the local cable or telephone bill, or about |
| appointments, no long waits for appointments or | | | | the same as what a family would spend eating |
| prescription refills, direct access to your personal | | | | out at a restaurant once a week. |