Photo (cc) by Seattle Municipal Archives
An apple a day may help keep the doctor away, but if you have to see him right now? You’re going to need a lot of something that doesn’t grow on trees.
Instead of waiting days or weeks for a brief appointment with a physician, you can use what’s called concierge medicine, direct care, or perhaps most descriptively: retainer medicine. On top of the usual costs, patients pay an annual retainer fee – ranging from hundreds to thousands, depending on the practice – to join a small group of patients who get special treatment, including same-day appointments and sometimes 24/7 access to the doctor.
In a typical practice, a family physician might have 1,000 patients or more. In a concierge practice, 400 is more typical. For patients, that translates into longer appointments, less waiting, and more personal attention. For doctors, it means a more satisfying and less stressful work day.
In the video below, Money Talks News founder Stacy Johnson talks to concierge doctor Steven Reznick and examines what this growing service offers, and at what cost. Check it out, then read on for more.
As Stacy mentioned, while it’s been around for more than a decade, this kind of practice is only just starting to take off – a government report [PDF] found 146 retainer physicians in 2005, but 756 last year. Last month, the American Academy of Private Physicians gave higher numbers, estimating “about 3,500 concierge doctors nationwide … [and] the number should double every 12 to 18 months for the next three years.”
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.
Dr. Reznick explains that when he began practicing in 1979, he’d see 10 to 12 patients per day – the same number he now sees in his concierge practice. But over the years, a decrease in revenue per patient meant he was forced to see more patients daily to maintain his standard of living. When he left his traditional practice, he was seeing 25 to 30 patients per day – typical, he says, of today’s family physician.
In short, the concierge physician charges an annual retainer simply to spend as much time with each patient as they did 30 years ago.
Is concierge care for you?
As Stacy said, you have to ask a lot of 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 the MedPAC.gov report mentioned above says that while concierge service is available in all but 11 states, it’s heavily concentrated in urban areas like Los Angeles, Miami, and Washington, D.C. 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, like: 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 fee isn’t standardized. The physician Stacy talked to in the video above charged $1,800 per year for individuals and $3,600 for families, which is about the average. The MedPAC report says “a typical retainer fee appears to be about $1,500 to $2,000, although the physicians we interviewed charge from $600 to $5,400.” Most, but not all, concierge doctors take insurance. You may also be able to pay in part through a work-based plan like an FSA or health savings account.
- Need. After knowing the perks and the price tag, the big question: Is it worth it? As Stacy mentioned, those with chronic conditions such as diabetes may appreciate more frequent and thorough care, as may older patients and those with multiple illnesses. Longer visits could also save both money and your health through early diagnosis. And for some impatient patients, the time saved alone – from being out sick or in the waiting room – may be worth the annual fee. If, that is, you can afford it.
For more on healthcare, see Health Care Reform = Free Preventive Care? Not Exactly, What to Do if You Can’t Afford Health Insurance, and 5 Tips to Pick the Right Hospital.