An apple a day may help keep the doctor away, but what if you have to see her right now? Instead of waiting days or weeks for a brief appointment with a physician, more and more patients are opting for what’s called concierge medicine, direct care, or — perhaps most descriptive — retainer medicine. Some 1.5 million Americans now use this approach to their health care, according to a recent report by NBC affiliate KING5-television.
The principle of concierge medicine is that patients pay their doctor an ongoing fee for the promise of more individualized and attentive care when the need arises.
That means that the experience of getting medical attention is quite different from what most of us are used to. Concierge practices usually serve no more than 600 patients, CNN Money says. For patients, that translates into more convenient scheduling, longer appointments, shorter wait times, and sometimes 24/7 access to communication with the physician and in some cases access to additional diagnostic testing. For many doctors, it means a more satisfying and less stressful work day.
There are various ways fees are charged: Some doctors ask for a subscription fee that can run from about $1,800 a year to as much as $20,000 a year. Some also take traditional insurance, some do not. In addition, some doctors charge fees for each visit.
Although you may think of a concierge doctor as a high-end option, in recent years another trend has taken hold and many concierge practices are charging lower fees for stripped-down services, reports The Wall Street Journal, quoting Concierge Medicine Today, a trade publication.
In this more affordable model, also called direct primary care, doctors don’t take insurance. That saves them about 40 percent of their overhead costs by cutting out billing, according to The Journal. Instead, patients pay a membership fee and also pay upfront and out of pocket for services as they receive them. Lists of fees usually are posted.
Just like the old days
The irony of retainer medicine is that what now constitutes concierge care used to be the standard, at least in terms of how many patients a doctor sees during an average day.
When Steven Reznick, an internist in Boca Raton, Florida, began practicing medicine in 1979, he’d see 10 to 12 patients per day. That’s about the same number he now sees in his concierge practice. In between, he says, he was earning less and less per patient, forcing him to see more patients daily — as many as 25 to 30 — to maintain his standard of living.
Is concierge care for you?
To know if a retainer-physician is right for you means getting answers to some questions. Here are a few things to consider:
- Distance: Is there a concierge practice near you? Some physicians keep their traditional practice as well, so they aren’t always mutually exclusive. But concierge medicine is a new field, and you may not find a provider, or at least a convenient one, in your area. You can look up concierge physicians in your area at the American Academy of Private Physicians website.
- Services: There’s no standard definition of what constitutes concierge service, so ask a lot of questions, such as: Are there same-day appointments? Is there 24/7 access to the doctor (or an assistant?) How much time am I guaranteed with the doctor? Does the doctor do house calls, more extensive tests, or email consultations? What kind of preventive care, such as screening exams or wellness plans, is included? What else is included? In short, find out what you’re paying extra for.
- Price: Like the service, the fees are not standardized. As we noted above, patient costs can vary widely. Some concierge doctors take insurance, others don’t. Be sure you understand clearly the fee system and what you may be paying out of pocket before you sign up. You may also be able to pay in part through a work-based plan like a Health Savings Account (HSA) or a Flexible Spending Account (FSA).
- Need: After knowing the perks and the price tag, the big question: Is it worth it? If you have chronic conditions such as diabetes or heart disease, you may appreciate more frequent and thorough care. Many older patients and those with multiple illnesses also get a lot from retainer-based physicians. You might even save money and your health, given the possibility for longer office visits and the potential for early diagnosis. For some impatient patients, the time saved – from being out sick or in the waiting room – may be worth the annual fee.
Are you considering a change from your current health care situation? Share with us in comments below or on our Facebook page.
Marilyn Lewis contributed to this post.