Amazon One Medical offer

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Topic Author
Theseus
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Joined: Sat Jan 23, 2016 8:40 am

Amazon One Medical offer

Post by Theseus »

Got an email from Amazon offering One Medical membership for annual special cost of $144 (instead of $199). Has anyone used this or One Medical? I was looking for positive or negative experiences. It is not clear I change my primary care doctor or not? And how it impacts my health insurance. But this is very tempting, considering I am healthy and don't have reason to see doctor - but when I do see them, it takes hours (far from house + always wait of 1-2 hrs past the appointment time).

It provides following
• 24/7 virtual care via messaging or video
• Online appointment booking
• On-demand video chat
• In-app prescription requests and renewals
One Medical also offers exceptional primary care, helping with everything from common illnesses to chronic diseases and mental health concerns.
• Access to offices in many U.S. cities and the ability to schedule a remote visit with your provider
• Appointments that start on time
• Drop-in lab services at One Medical offices
• Message a provider in the app
• Compassionate doctors and providers who take time to listen
jebmke
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Re: Amazon One Medical offer

Post by jebmke »

Do they accept your insurance?
When you discover that you are riding a dead horse, the best strategy is to dismount.
Topic Author
Theseus
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Re: Amazon One Medical offer

Post by Theseus »

jebmke wrote: Sat May 13, 2023 6:03 am Do they accept your insurance?
Yes. They do. I am not sure what it means. Do I have to change my PCP? I couldn't find that information on their site - perhaps I missed it.
jebmke
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Re: Amazon One Medical offer

Post by jebmke »

Theseus wrote: Sat May 13, 2023 6:07 am
jebmke wrote: Sat May 13, 2023 6:03 am Do they accept your insurance?
Yes. They do. I am not sure what it means. Do I have to change my PCP? I couldn't find that information on their site - perhaps I missed it.
That is probably more a function of your insurance than their product. I’m in traditional Medicare. I can see any provider who accepts Medicare. I have. PCP but I am not required to use him exclusively.
When you discover that you are riding a dead horse, the best strategy is to dismount.
Topic Author
Theseus
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Re: Amazon One Medical offer

Post by Theseus »

jebmke wrote: Sat May 13, 2023 6:11 am
Theseus wrote: Sat May 13, 2023 6:07 am
jebmke wrote: Sat May 13, 2023 6:03 am Do they accept your insurance?
Yes. They do. I am not sure what it means. Do I have to change my PCP? I couldn't find that information on their site - perhaps I missed it.
That is probably more a function of your insurance than their product. I’m in traditional Medicare. I can see any provider who accepts Medicare. I have. PCP but I am not required to use him exclusively.
Thanks. I have open access plan where I can also see any doctor I want. But I have only used that for specialists (Ortho, Cardiologist etc.). Never for PCP.
Rex66
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Joined: Tue Aug 04, 2020 5:13 pm

Re: Amazon One Medical offer

Post by Rex66 »

It appears to be a service that works with your insurance.

These are just too new to know how valuable the service is but I’d say at the moment that it would be most valuable if they work with your insurance and you have previously noted difficulties finding doctors who accept your insurance. Having someone do that work for you can be valuable.
jeam3131
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Re: Amazon One Medical offer

Post by jeam3131 »

These services are all based on the backbone of using the lowest, cheapest, and resulting bottom of the barrel trained "doctors". They're just peddling undertrained nurse practioners, physician assistants etc. You know it's a charade when you see the title DNP AAFP BLS.....

Is it convenient? Sure. But what's the quality?
safari
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Re: Amazon One Medical offer

Post by safari »

I looked into it a few months ago when I received a similar offer. It sounded good in theory, but when I read the reviews of the medical office closest to me, they were really bad. The so-called "doctors" were really inexperienced young medical practicioners who couldn't properly diagnose anything, while charging high fees for the visit. Yes, it was easy getting an appointment, but it was a complete waste of time for most people who left the reviews.
jebmke
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Re: Amazon One Medical offer

Post by jebmke »

One of my worries is whether they are going to go down the same path of decline as Whole Foods now that AMZ owns them.
When you discover that you are riding a dead horse, the best strategy is to dismount.
stan1
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Re: Amazon One Medical offer

Post by stan1 »

safari wrote: Sat May 13, 2023 8:39 am I looked into it a few months ago when I received a similar offer. It sounded good in theory, but when I read the reviews of the medical office closest to me, they were really bad. The so-called "doctors" were really inexperienced young medical practicioners who couldn't properly diagnose anything, while charging high fees for the visit. Yes, it was easy getting an appointment, but it was a complete waste of time for most people who left the reviews.
It's not the place to go if you have complex medical issues that need a diagnosis. OP stated they see other specialists so I'd recommend a PCP to them that is in the same provider network and who uses the same electronic health care record system so that all physicians can see their medical histories. In my case my PCP doesn't do next day appointments so I go to the provider networks urgent care where all of my records are available when I walk in the door. People who have PCPs that do same day and next day appointments assume every PCP can do that; that's not the case. There are reasons I stay with my PCP even though she does not do next day appointments and the trips to urgent care are once every three to five years (infrequent).
humblecoder
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Re: Amazon One Medical offer

Post by humblecoder »

Theseus wrote: Sat May 13, 2023 5:52 am It provides following
• 24/7 virtual care via messaging or video
• Online appointment booking
• On-demand video chat
• In-app prescription requests and renewals
One Medical also offers exceptional primary care, helping with everything from common illnesses to chronic diseases and mental health concerns.
• Access to offices in many U.S. cities and the ability to schedule a remote visit with your provider
• Appointments that start on time
• Drop-in lab services at One Medical offices
• Message a provider in the app
• Compassionate doctors and providers who take time to listen
Interesting service. From reading about it on their website, it sounds like you still have to go through your own insurance coverage, pay any deductible/co-pays out of pocket. So what are you getting exactly for your $144-$199/year?

My primary doctor belongs to a regional medical group and I get most of the above features through their patient portal for free. I've booked appointments online, I've had telemedicine virtual appointments with my doctor. I can request prescription renewals online. They have an on-site lab to get my bloodwork done, or I can go to one of the many free standing labs in my area. All for zero additional fee.

It is possible that my doctor's medical group is an outlier, but I have to believe that other medical groups must offer services like this.

BTW, if I have to pay an extra $144/year for "compassionate doctors and providers who take the time to listen", then something is broken!
safari
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Re: Amazon One Medical offer

Post by safari »

stan1 wrote: Sat May 13, 2023 8:47 am
safari wrote: Sat May 13, 2023 8:39 am I looked into it a few months ago when I received a similar offer. It sounded good in theory, but when I read the reviews of the medical office closest to me, they were really bad. The so-called "doctors" were really inexperienced young medical practicioners who couldn't properly diagnose anything, while charging high fees for the visit. Yes, it was easy getting an appointment, but it was a complete waste of time for most people who left the reviews.
It's not the place to go if you have complex medical issues that need a diagnosis. OP stated they see other specialists so I'd recommend a PCP to them that is in the same provider network and who uses the same electronic health care record system so that all physicians can see their medical histories. In my case my PCP doesn't do next day appointments so I go to the provider networks urgent care where all of my records are available when I walk in the door. People who have PCPs that do same day and next day appointments assume every PCP can do that; that's not the case. There are reasons I stay with my PCP even though she does not do next day appointments and the trips to urgent care are once every three to five years (infrequent).
I also go to urgent care whenever I need to see a doctor and can't wait for an appointment. It costs less than Amazon One charges per visit, and there is no annual membership fee. This service appears to be completely useless, at least to me.
toddthebod
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Re: Amazon One Medical offer

Post by toddthebod »

jeam3131 wrote: Sat May 13, 2023 7:06 am These services are all based on the backbone of using the lowest, cheapest, and resulting bottom of the barrel trained "doctors". They're just peddling undertrained nurse practioners, physician assistants etc. You know it's a charade when you see the title DNP AAFP BLS.....

Is it convenient? Sure. But what's the quality?
Way to disparage two entire professions.
jeam3131
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Re: Amazon One Medical offer

Post by jeam3131 »

toddthebod wrote: Sat May 13, 2023 9:18 am
jeam3131 wrote: Sat May 13, 2023 7:06 am These services are all based on the backbone of using the lowest, cheapest, and resulting bottom of the barrel trained "doctors". They're just peddling undertrained nurse practioners, physician assistants etc. You know it's a charade when you see the title DNP AAFP BLS.....

Is it convenient? Sure. But what's the quality?
Way to disparage two entire professions.
It's not disparaging. It's misuse. These professions have their place in healthcare. The public deserves to know and understand who they're seeing and their level of training. Is that too much to ask for?
jebmke
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Re: Amazon One Medical offer

Post by jebmke »

jeam3131 wrote: Sat May 13, 2023 9:25 am
toddthebod wrote: Sat May 13, 2023 9:18 am
jeam3131 wrote: Sat May 13, 2023 7:06 am These services are all based on the backbone of using the lowest, cheapest, and resulting bottom of the barrel trained "doctors". They're just peddling undertrained nurse practioners, physician assistants etc. You know it's a charade when you see the title DNP AAFP BLS.....

Is it convenient? Sure. But what's the quality?
Way to disparage two entire professions.
It's not disparaging. It's misuse. These professions have their place in healthcare. The public deserves to know and understand who they're seeing and their level of training. Is that too much to ask for?
Do they not disclose who is in the practice? My PCP is part of a practice that has a mix of MDs, DOs, NPs, PAs. I have no evidence that the PA I often see is undertrained. He is a former ER nurse. What makes you think the PAs and NPs at One Medical have not received the required training for their profession?
When you discover that you are riding a dead horse, the best strategy is to dismount.
toddthebod
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Re: Amazon One Medical offer

Post by toddthebod »

jeam3131 wrote: Sat May 13, 2023 9:25 am
toddthebod wrote: Sat May 13, 2023 9:18 am
jeam3131 wrote: Sat May 13, 2023 7:06 am These services are all based on the backbone of using the lowest, cheapest, and resulting bottom of the barrel trained "doctors". They're just peddling undertrained nurse practioners, physician assistants etc. You know it's a charade when you see the title DNP AAFP BLS.....

Is it convenient? Sure. But what's the quality?
Way to disparage two entire professions.
It's not disparaging. It's misuse. These professions have their place in healthcare. The public deserves to know and understand who they're seeing and their level of training. Is that too much to ask for?
"Bottom of the barrel" isn't disparaging? A "charade"? Please. Virtually every study ever done on quality of care for nurse practitioners versus medical doctors has found the NPs provide equivalent or higher quality care.
InMyDreams
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Re: Amazon One Medical offer

Post by InMyDreams »

You may be interested in this privacy concern raised by WaPo and reported by NPR
Amazon's 'affordable' health care service has a hidden cost: your privacy
https://www.npr.org/2023/05/06/11744687 ... ur-privacy
Young Boglehead
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Re: Amazon One Medical offer

Post by Young Boglehead »

jebmke wrote: Sat May 13, 2023 9:29 am
jeam3131 wrote: Sat May 13, 2023 9:25 am
toddthebod wrote: Sat May 13, 2023 9:18 am
jeam3131 wrote: Sat May 13, 2023 7:06 am These services are all based on the backbone of using the lowest, cheapest, and resulting bottom of the barrel trained "doctors". They're just peddling undertrained nurse practioners, physician assistants etc. You know it's a charade when you see the title DNP AAFP BLS.....

Is it convenient? Sure. But what's the quality?
Way to disparage two entire professions.
It's not disparaging. It's misuse. These professions have their place in healthcare. The public deserves to know and understand who they're seeing and their level of training. Is that too much to ask for?
Do they not disclose who is in the practice? My PCP is part of a practice that has a mix of MDs, DOs, NPs, PAs. I have no evidence that the PA I often see is undertrained. He is a former ER nurse. What makes you think the PAs and NPs at One Medical have not received the required training for their profession?
There’s not much (if any) standardization in training after PA/NP school. As a med student I’ve always found it perplexing that it takes a minimum of 7 years of med school/residency to be qualified to practice in one area of medicine yet for PAs for example it’s 2.5 yrs and they end up able to practice in whatever field will hire them.

Just finished my 3rd year of med school and I’m still a baby with so much ahead of me, whereas if I was a PA I’d be seeing patients like yourself already
katnok
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Re: Amazon One Medical offer

Post by katnok »

jeam3131 wrote: Sat May 13, 2023 9:25 am
toddthebod wrote: Sat May 13, 2023 9:18 am
jeam3131 wrote: Sat May 13, 2023 7:06 am These services are all based on the backbone of using the lowest, cheapest, and resulting bottom of the barrel trained "doctors". They're just peddling undertrained nurse practioners, physician assistants etc. You know it's a charade when you see the title DNP AAFP BLS.....

Is it convenient? Sure. But what's the quality?
Way to disparage two entire professions.
It's not disparaging. It's misuse. These professions have their place in healthcare. The public deserves to know and understand who they're seeing and their level of training. Is that too much to ask for?
+1.
People absolutely deserve to know who they are seeing, and more importantly, their credentials. Getting a DNP is so easy these days. I know of an NP who was able to maintain her full time job and complete her DNP completely online in less than 2 yrs. Now, they get to call themselves "doctor XYZ". General public simply has no idea how any of this actually works, and they believe they are actually seeing a physician (MD or DO).
Young Boglehead
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Re: Amazon One Medical offer

Post by Young Boglehead »

toddthebod wrote: Sat May 13, 2023 9:37 am
jeam3131 wrote: Sat May 13, 2023 9:25 am
toddthebod wrote: Sat May 13, 2023 9:18 am
jeam3131 wrote: Sat May 13, 2023 7:06 am These services are all based on the backbone of using the lowest, cheapest, and resulting bottom of the barrel trained "doctors". They're just peddling undertrained nurse practioners, physician assistants etc. You know it's a charade when you see the title DNP AAFP BLS.....

Is it convenient? Sure. But what's the quality?
Way to disparage two entire professions.
It's not disparaging. It's misuse. These professions have their place in healthcare. The public deserves to know and understand who they're seeing and their level of training. Is that too much to ask for?
"Bottom of the barrel" isn't disparaging? A "charade"? Please. Virtually every study ever done on quality of care for nurse practitioners versus medical doctors has found the NPs provide equivalent or higher quality care.
PAs/NPs are important to American healthcare but I don't think I've ever seen a credible study (especially not done by the AANP for example) finding they're higher quality. It doesn't make sense on its face... would you want an NP/PA doing your open heart surgery? Then why as your "neurologist" etc
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Re: Amazon One Medical offer

Post by Raybo »

Last year, I got a small settlement from One Medical because they charged me money to use their on-line portal without telling me I didn't have to use it or pay for it.

I spent a year using them and was thoroughly disappointed. The doctor I was assigned was clearly in his first year of practice and wasn't very good at his job yet. The first/only time I saw him, he told me that I was supposed to get my tests done before I saw him. No one told me this and he never ordered any tests for me. So, I went an entire year without any blood tests whatsoever. The next time I asked for an appointment, he didn't have any. I returned to Kaiser (Medicare Advantage) after that one year and haven't look back since.

My wife uses them for her PCP and seems to be satisfied though she rarely contacts them, using specialists at UCSF when she needs some care.
No matter how long the hill, if you keep pedaling you'll eventually get up to the top.
katnok
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Re: Amazon One Medical offer

Post by katnok »

Young Boglehead wrote: Sat May 13, 2023 9:47 am
toddthebod wrote: Sat May 13, 2023 9:37 am
jeam3131 wrote: Sat May 13, 2023 9:25 am
toddthebod wrote: Sat May 13, 2023 9:18 am
jeam3131 wrote: Sat May 13, 2023 7:06 am These services are all based on the backbone of using the lowest, cheapest, and resulting bottom of the barrel trained "doctors". They're just peddling undertrained nurse practioners, physician assistants etc. You know it's a charade when you see the title DNP AAFP BLS.....

Is it convenient? Sure. But what's the quality?
Way to disparage two entire professions.
It's not disparaging. It's misuse. These professions have their place in healthcare. The public deserves to know and understand who they're seeing and their level of training. Is that too much to ask for?
"Bottom of the barrel" isn't disparaging? A "charade"? Please. Virtually every study ever done on quality of care for nurse practitioners versus medical doctors has found the NPs provide equivalent or higher quality care.
PAs/NPs are important to American healthcare but I don't think I've ever seen a credible study (especially not done by the AANP for example) finding they're higher quality. It doesn't make sense on its face... would you want an NP/PA doing your open heart surgery? Then why as your "neurologist" etc
Right. How exactly can someone with less training provide better care?
Also, how can someone be a pediatric NP on friday, and then join a derm practice the following monday, and call themselves a derm NP? This just doesn't right. Money is absolutely at the center of all of this stuff that's happening to the healthcare.
Young Boglehead
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Re: Amazon One Medical offer

Post by Young Boglehead »

katnok wrote: Sat May 13, 2023 9:50 am
Young Boglehead wrote: Sat May 13, 2023 9:47 am
toddthebod wrote: Sat May 13, 2023 9:37 am
jeam3131 wrote: Sat May 13, 2023 9:25 am
toddthebod wrote: Sat May 13, 2023 9:18 am

Way to disparage two entire professions.
It's not disparaging. It's misuse. These professions have their place in healthcare. The public deserves to know and understand who they're seeing and their level of training. Is that too much to ask for?
"Bottom of the barrel" isn't disparaging? A "charade"? Please. Virtually every study ever done on quality of care for nurse practitioners versus medical doctors has found the NPs provide equivalent or higher quality care.
PAs/NPs are important to American healthcare but I don't think I've ever seen a credible study (especially not done by the AANP for example) finding they're higher quality. It doesn't make sense on its face... would you want an NP/PA doing your open heart surgery? Then why as your "neurologist" etc
Right. How exactly can someone with less training provide better care?
There's definitely a point where more training isn't necessarily better and medicine has got there in some respects; I don't think it necessarily needs to be as long as it is in many pathways. But it still needs to be rigorous and standardized.
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ResearchMed
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Re: Amazon One Medical offer

Post by ResearchMed »

katnok wrote: Sat May 13, 2023 9:44 am +1.
People absolutely deserve to know who they are seeing, and more importantly, their credentials. Getting a DNP is so easy these days. I know of an NP who was able to maintain her full time job and complete her DNP completely online in less than 2 yrs. Now, they get to call themselves "doctor XYZ". General public simply has no idea how any of this actually works, and they believe they are actually seeing a physician (MD or DO).

Perhaps it is a different "doctor" degree, but when I was in grad school (yes, a long time ago, so things may well have changed), there were 2 "outside" (other department) grad students taking a few of our courses.
They were RNs, each planning on a Ph.D. in Nursing.

But it was explicit that they were heading for administrative jobs.
They were studying about research methods, also taking courses at the Business School, etc.
Yes, a very different type of "Doctor".
And these were multi-year, full-time programs.
This may be different than the DNP...?

RM
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jeam3131
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Re: Amazon One Medical offer

Post by jeam3131 »

toddthebod wrote: Sat May 13, 2023 9:37 am
jeam3131 wrote: Sat May 13, 2023 9:25 am
toddthebod wrote: Sat May 13, 2023 9:18 am
jeam3131 wrote: Sat May 13, 2023 7:06 am These services are all based on the backbone of using the lowest, cheapest, and resulting bottom of the barrel trained "doctors". They're just peddling undertrained nurse practioners, physician assistants etc. You know it's a charade when you see the title DNP AAFP BLS.....

Is it convenient? Sure. But what's the quality?
Way to disparage two entire professions.
It's not disparaging. It's misuse. These professions have their place in healthcare. The public deserves to know and understand who they're seeing and their level of training. Is that too much to ask for?
"Bottom of the barrel" isn't disparaging? A "charade"? Please. Virtually every study ever done on quality of care for nurse practitioners versus medical doctors has found the NPs provide equivalent or higher quality care.
The entire economics of these online healthcare businesses (and sadly, hospitals too) is cheap labor. Without it, they wouldn't be profitable. Would you rather hire 20 doctors? Or have one doctor rent out their medical license and "supervise" 20 midlevels who have no specitialy specific/standardized/regulated training?

How would you feel if a pilot wasn't on your plane, but rather a pilot assistant that's being "supervised" by a pilot on the ground who's simultaneously "supervising" 20 other flights?

Here is a book that delves deep into the topic. It uses evidence and objectivity. It's very eye opening.

https://www.amazon.com/Patients-Risk-Pr ... 5291&psc=1
Rex66
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Re: Amazon One Medical offer

Post by Rex66 »

toddthebod wrote: Sat May 13, 2023 9:37 am
jeam3131 wrote: Sat May 13, 2023 9:25 am
toddthebod wrote: Sat May 13, 2023 9:18 am
jeam3131 wrote: Sat May 13, 2023 7:06 am These services are all based on the backbone of using the lowest, cheapest, and resulting bottom of the barrel trained "doctors". They're just peddling undertrained nurse practioners, physician assistants etc. You know it's a charade when you see the title DNP AAFP BLS.....

Is it convenient? Sure. But what's the quality?
Way to disparage two entire professions.
It's not disparaging. It's misuse. These professions have their place in healthcare. The public deserves to know and understand who they're seeing and their level of training. Is that too much to ask for?
"Bottom of the barrel" isn't disparaging? A "charade"? Please. Virtually every study ever done on quality of care for nurse practitioners versus medical doctors has found the NPs provide equivalent or higher quality care.
That’s just not the truth. There are no residencies for NPs. They all come out of training with insufficient knowledge to practice independently. We put all ours through a 2year program. There was once a time when NP was degree only given to nurses who had practiced in the field for a very long time. They were all great. Now it’s an immediate additional degree after nursing school with zero practice experience. The worst is how those programs don’t even have rotations lined up for their students in many programs. The students have to go out and beg practitioners to take them on.
Super Hans
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Re: Amazon One Medical offer

Post by Super Hans »

jeam3131 wrote: Sat May 13, 2023 7:06 am These services are all based on the backbone of using the lowest, cheapest, and resulting bottom of the barrel trained "doctors". They're just peddling undertrained nurse practioners, physician assistants etc. You know it's a charade when you see the title DNP AAFP BLS.....

Is it convenient? Sure. But what's the quality?
+1. I used One Medical for a couple of years when my insurance gave me free membership. I found one internist I liked in my metro area, but I don’t know if there was even one alternative: dozens of paraprofessionals and such. The business model clearly is to get those who don’t know the difference to pay high prices to see low-salaried folks.
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Re: Amazon One Medical offer

Post by nisiprius »

InMyDreams wrote: Sat May 13, 2023 9:41 am You may be interested in this privacy concern raised by WaPo and reported by NPR
Amazon's 'affordable' health care service has a hidden cost: your privacy
https://www.npr.org/2023/05/06/11744687 ... ur-privacy
^This.
Before you're allowed to officially become a patient of Amazon Clinic, they make you click one of those little buttons that says continue or I agree. And there's a whole bunch of legalese that you're agreeing to there. At the top, it says, a HIPAA authorization. And I think a lot of listeners, anybody who's been to a doctor's office in the last couple of decades, might think, oh, yes, yes, HIPAA, that's normal. But this case turns out to be different. What Amazon is asking patients to do is to essentially give up some of their federally protected privacy rights. And that really should raise the eyebrows of anybody who wants to understand what big tech is doing getting into health care....

....their website for Amazon Clinic makes lots of promises about HIPAA, but then asks you to sign a document that says you're no longer covered by HIPAA.
Annual income twenty pounds, annual expenditure nineteen nineteen and six, result happiness; Annual income twenty pounds, annual expenditure twenty pounds ought and six, result misery.
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Re: Amazon One Medical offer

Post by JAZZISCOOL »

jebmke wrote: Sat May 13, 2023 8:46 am One of my worries is whether they are going to go down the same path of decline as Whole Foods now that AMZ owns them.
FWIW, another consideration for those with privacy concerns....I think it was on the Clark Howard podcast recently that said you have to accept Amazon acquiring your medical data if you accept this One Medical service. I think someone on his staff read the legal disclaimers, etc. So HIPAA would not apply the way it does with your normal doctor's office is the way I understood the concern. That may be an issue. :(
JDave
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Re: Amazon One Medical offer

Post by JDave »

"considering I am healthy and don't have reason to see doctor" Everyone is and don't, until they aren't and do.
Dmanse02
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Re: Amazon One Medical offer

Post by Dmanse02 »

toddthebod wrote: Sat May 13, 2023 9:37 am
jeam3131 wrote: Sat May 13, 2023 9:25 am
toddthebod wrote: Sat May 13, 2023 9:18 am
jeam3131 wrote: Sat May 13, 2023 7:06 am These services are all based on the backbone of using the lowest, cheapest, and resulting bottom of the barrel trained "doctors". They're just peddling undertrained nurse practioners, physician assistants etc. You know it's a charade when you see the title DNP AAFP BLS.....

Is it convenient? Sure. But what's the quality?
Way to disparage two entire professions.
It's not disparaging. It's misuse. These professions have their place in healthcare. The public deserves to know and understand who they're seeing and their level of training. Is that too much to ask for?
"Bottom of the barrel" isn't disparaging? A "charade"? Please. Virtually every study ever done on quality of care for nurse practitioners versus medical doctors has found the NPs provide equivalent or higher quality care.


As other have stated, this is incorrect. I’m not sure where you are getting your information, but like a lot of people in today’s world, you need a new source or you need to read the PRIMARY literature yourself.
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southerndoc
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Re: Amazon One Medical offer

Post by southerndoc »

toddthebod wrote: Sat May 13, 2023 9:37 am
jeam3131 wrote: Sat May 13, 2023 9:25 am
toddthebod wrote: Sat May 13, 2023 9:18 am
jeam3131 wrote: Sat May 13, 2023 7:06 am These services are all based on the backbone of using the lowest, cheapest, and resulting bottom of the barrel trained "doctors". They're just peddling undertrained nurse practioners, physician assistants etc. You know it's a charade when you see the title DNP AAFP BLS.....

Is it convenient? Sure. But what's the quality?
Way to disparage two entire professions.
It's not disparaging. It's misuse. These professions have their place in healthcare. The public deserves to know and understand who they're seeing and their level of training. Is that too much to ask for?
"Bottom of the barrel" isn't disparaging? A "charade"? Please. Virtually every study ever done on quality of care for nurse practitioners versus medical doctors has found the NPs provide equivalent or higher quality care.
Please point me to these studies. The studies I've seen have shown higher utilization costs, higher CT utilization, and higher readmission rates for NPs as opposed to physicians. Definitely would be interested in seeing the peer-reviewed studies that show that NPs can provide equivalent or even higher quality care.
Dmanse02
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Re: Amazon One Medical offer

Post by Dmanse02 »

southerndoc wrote: Sat May 13, 2023 2:26 pm
toddthebod wrote: Sat May 13, 2023 9:37 am
jeam3131 wrote: Sat May 13, 2023 9:25 am
toddthebod wrote: Sat May 13, 2023 9:18 am
jeam3131 wrote: Sat May 13, 2023 7:06 am These services are all based on the backbone of using the lowest, cheapest, and resulting bottom of the barrel trained "doctors". They're just peddling undertrained nurse practioners, physician assistants etc. You know it's a charade when you see the title DNP AAFP BLS.....

Is it convenient? Sure. But what's the quality?
Way to disparage two entire professions.
It's not disparaging. It's misuse. These professions have their place in healthcare. The public deserves to know and understand who they're seeing and their level of training. Is that too much to ask for?
"Bottom of the barrel" isn't disparaging? A "charade"? Please. Virtually every study ever done on quality of care for nurse practitioners versus medical doctors has found the NPs provide equivalent or higher quality care.
Please point me to these studies. The studies I've seen have shown higher utilization costs, higher CT utilization, and higher readmission rates for NPs as opposed to physicians. Definitely would be interested in seeing the peer-reviewed studies that show that NPs can provide equivalent or even higher quality care.
Forgot more inappropriate antibiotic usage
4Health
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Re: Amazon One Medical offer

Post by 4Health »

jebmke wrote: Sat May 13, 2023 9:29 am
jeam3131 wrote: Sat May 13, 2023 9:25 am
toddthebod wrote: Sat May 13, 2023 9:18 am
jeam3131 wrote: Sat May 13, 2023 7:06 am These services are all based on the backbone of using the lowest, cheapest, and resulting bottom of the barrel trained "doctors". They're just peddling undertrained nurse practioners, physician assistants etc. You know it's a charade when you see the title DNP AAFP BLS.....

Is it convenient? Sure. But what's the quality?
Way to disparage two entire professions.
It's not disparaging. It's misuse. These professions have their place in healthcare. The public deserves to know and understand who they're seeing and their level of training. Is that too much to ask for?
Do they not disclose who is in the practice? My PCP is part of a practice that has a mix of MDs, DOs, NPs, PAs. I have no evidence that the PA I often see is undertrained. He is a former ER nurse. What makes you think the PAs and NPs at One Medical have not received the required training for their profession?
A new grad PA is the equivalent of a medical student who has completed their 3rd year at best. They complete one year of didactic/PBL based education and then one year of rotations (essentially the same rotations as a 3rd year medical student). A primary care physician (family practice or internal medicine) has 4 years of medical school (2 years of didactics + 2 years of rotations) plus 3 years of residency (equivalent of 10-12000 hours of training at 60-80hr week for 3 years). Overall Similar training for NP/DNP when compared to PA. Many DNP courses can be completed online.

I am only stating training requirements. It is up to you to decide who you feel more comfortable with providing care for you and your loved ones. It takes several years after residency for a new doctor to be very confident in their decision making. There is clearly a very important role for APPs (PA/NP) in our health system and it couldn’t function without them, but I don’t think the field of primary care is it without very close collaboration. It is too broad. A good PCP is worth their weight in gold.
orangecrushv
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Re: Amazon One Medical offer

Post by orangecrushv »

I’m just in the first year using them but no complaints so far…. I’m in a city where 1) they don’t have enough doctors so the wait to get in as a new patient anywhere else is usually months and 2) you probably want to avoid ERs and Urgent Cares… so the availability for the basics was a key selling point.
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Theseus
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Re: Amazon One Medical offer

Post by Theseus »

OP Here.

Thank you all for fairly informative replies. I was aware of privacy issue in their disclaimer and NPR story. But I am not concerned about that.

But I would not like an NP when I specifically want a certified doctor. However I don't know how this is different from the traditional places that are pushing NPs. I had an appointment with an Ortho (hand & shoulder specialist) for a sever pain my my hand. I assumed (wrongly :oops: ) that I will see the doctor. Well a nurse comes in - I was not on doctor's schedule. I should have made a stink - but Ortho is a friend of a family member and it would have been more drama. While he is rated consistently top 10 Ortho in his area, there was a sort of a misdiagnosis (not relevant to the discussion here) which months later a second opinion from another hand specialist confirmed.

Most of my friends are doctors of some speciality. I believe they are all very competent, and trying to do right thing for their patients. But every discussion usually is about money and reimbursement.So pushing NPs, other cash business etc is a clear motivation. What I am trying to say is that NP instead of a doctor is not a problem with just One Medical. This is becoming industry problem. I have to find a way to deal with it whether it is traditional medicine of something like amazon/one medical.
anil686
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Re: Amazon One Medical offer

Post by anil686 »

Theseus wrote: Sat May 13, 2023 3:35 pm OP Here.

Thank you all for fairly informative replies. I was aware of privacy issue in their disclaimer and NPR story. But I am not concerned about that.

But I would not like an NP when I specifically want a certified doctor. However I don't know how this is different from the traditional places that are pushing NPs. I had an appointment with an Ortho (hand & shoulder specialist) for a sever pain my my hand. I assumed (wrongly :oops: ) that I will see the doctor. Well a nurse comes in - I was not on doctor's schedule. I should have made a stink - but Ortho is a friend of a family member and it would have been more drama. While he is rated consistently top 10 Ortho in his area, there was a sort of a misdiagnosis (not relevant to the discussion here) which months later a second opinion from another hand specialist confirmed.

Most of my friends are doctors of some speciality. I believe they are all very competent, and trying to do right thing for their patients. But every discussion usually is about money and reimbursement.So pushing NPs, other cash business etc is a clear motivation. What I am trying to say is that NP instead of a doctor is not a problem with just One Medical. This is becoming industry problem. I have to find a way to deal with it whether it is traditional medicine of something like amazon/one medical.
You may want to discuss this with your non physician friends. Physician here (full disclosure). We are one of the few practices in our area that do not have extenders (PAs or NPs). We are definitely in the minority and we have looked at adding them but have not. Over the past three years, we have grown by about 75% in our outpatient clinic and one of the first things we see from new patient referrals is that they know we do not have extenders. They say they heard from their friends you always see one of the two doctors in the practice - no NPs, no PAs. Now we have nothing against PAs or NPs but when you make an appt with your physician, most people expect it to be with their physician. I know our practice is not unique - again - would recommend talking with your friends who are not physicians about where they go and do they know of any practices that do not have NPs or PAs - most places have at least a few practices like these - but we are typically harder to find because we do not spend money on SEO, we do not have a huge marketing budget so we are not on TV or radio, we cannot afford rent in expensive medical districts. You can think of us - IMO - as your successful mechanics in town that do the right thing but are hard to find in comparison to dealers that are everywhere - JMO though....

You can discuss this with your physician friends but if they are like me, they are always going to see a fellow physician even when that practice is staffed with NPs and PAs out of professional courtesy so I don't think they will understand exactly what you are saying. I once went to my physician who has an NP in the practice and somehow I had an appt with him but was placed with her. I never identify myself as a physician to this practice and was seen by an NP. The NP finished the visit and and as we were walking to the front I saw my colleague who is my physician. He had them re-room me and he did the visit as well. Just putting this last story in to let you know that physicians know there is a difference in training - not that it is always important but if you are paying the same for a visit, the expectation is that you would be seen by a physician. Again JMO....
bendix
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Re: Amazon One Medical offer

Post by bendix »

Finding good doctors is difficult enough, even if you go to a brick and mortar doctor. As I am a man full of prejudices, I feel very comfortable saying that while it´s difficult to tell where to find a good doctor, it´s often times fairly easy to spot where you wont find one. And if this company had good doctors, I´d be shocked.
Super Hans
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Re: Amazon One Medical offer

Post by Super Hans »

anil686 wrote: Sat May 13, 2023 4:55 pm * * *Just putting this last story in to let you know that physicians know there is a difference in training - not that it is always important but if you are paying the same for a visit, the expectation is that you would be seen by a physician. Again JMO....
That might be what's most crazy: paying the same whether you're getting the 300th Anniversary University Professor or a nurse. Here, One Medical charges a fee for access on top of the professional services fees, but it appears a lot of that access, especially for last-minute appointments or email contact, won't be with an internist.

Besides the quantity of training that's been discussed here, there's also something to be said for the quality. I remember being in high school and agonizing over my future if I took the Calculus A/B exam instead of the B/C one. And then in college worrying about the possibility of not getting an A in organic chemistry or physics. I think you can bypass all this with the paraprofessional tracks. Maybe that's ok, but we had to go through all of that so they'd weed out the kids who weren't ready for some serious critical thinking and problem solving.
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Re: Amazon One Medical offer

Post by nisiprius »

It seems odd that Amazon is announcing this at almost the same time as I am hearing ads for some new product from Teledoc involving primary care. (Search) Teledoc Primary360.

I wonder if Amazon One is a private-badged version of Teledoc Primary360.
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acs02001
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Re: Amazon One Medical offer

Post by acs02001 »

Psychiatrist here. This past week I was asked to see a patient who was being managed by an NP in a rural setting. Patient was horribly misdiagnosed and mismanaged. A $5k/month medication was prescribed and not at all indicated AND was duplicative of another medication (also not indicated) that the patient was receiving. These were high-risk medications. Scary. Although some NPs and PAs are fantastic (and some MDs/DOs are horrible), I often see a quick pattern recognition approach to medicine that can result in premature closure (i.e., see X, do Y). When something unusual happens (e.g., a psychiatric symptom caused by an underlying neurological condition, medication side effect, etc) it can get misdiagnosed and mistreated. Sometimes to dangerous effect. No matter how much venture capital, health insurance plans, and MBA hospital administrators would wish otherwise, sometimes there is no substitute for a 4-year medical school education plus a 3-7 year residency (+/- fellowship).
SuzBanyan
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Re: Amazon One Medical offer

Post by SuzBanyan »

I was scolded by my new cardiologist on a recent visit for previously seeing a PA in their office as part of my annual check-up because my condition required monitoring by a physician. I actually laughed because it was never my choice whether I would see a physician or PA, it was the practice. I felt like I was lucky when I saw a physician every other year. I do understand that when you make appointments 12 months in advance, stuff happens. As the new cardiologist is new to the practice (replacing my cardiologist who moved who replaced my cardiologist who retired), it will be interesting to see if he is able to keep his promise that I will see him from now on.
SevenBridgesRoad
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Re: Amazon One Medical offer

Post by SevenBridgesRoad »

For me, from this thread it is a bit hard to grok what Amazon One Medical actually is. Maybe it's just me (very likely). But, I will back up the truck in case there's even one person that missed the part about Amazon acquiring a large, nationally spread-out medical practice. Amazon acquired a group practice called Medical One that appears to have been in business for perhaps 15 years. Looks like the deal closed in February. I make no claim as to the quality of the practice.

https://www.onemedical.com/mediacenter/ ... ns-amazon/
Jeepergeo
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Re: Amazon One Medical offer

Post by Jeepergeo »

toddthebod wrote: Sat May 13, 2023 9:18 am
jeam3131 wrote: Sat May 13, 2023 7:06 am These services are all based on the backbone of using the lowest, cheapest, and resulting bottom of the barrel trained "doctors". They're just peddling undertrained nurse practioners, physician assistants etc. You know it's a charade when you see the title DNP AAFP BLS.....

Is it convenient? Sure. But what's the quality?
Way to disparage two entire professions.
The medical "profession" is not good at taking constructive suggestions, and that "profession" has driven the state of health care to where it is today.

My medical "insurance" is through Kaiser Permanente in California, yet it seems that most of the few times when I need "health care", Kaiser Permanente has no issue with pawning me off to a PA or to an outside practice. I was recently sent by Kaiser to an outside practice for an annual check of a previously significant issue: when I arrived, I turned around and walked out because the practice looked like it was from a third world nation and the waiting room was filthy.

In my books, Kaiser Permanente went from a 5 Star rating before ACA and COVID, and once those events hit, I would not even rate KP 1 Star. It seems the greed of the "professionals" that share in owning KP have just one thing in mind, and it's not quality health care.

Maybe these "professionals" need to take a close look at their industry and make some changes before AI puts them out of business.
Young Boglehead
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Re: Amazon One Medical offer

Post by Young Boglehead »

Jeepergeo wrote: Sat May 13, 2023 7:53 pm
toddthebod wrote: Sat May 13, 2023 9:18 am
jeam3131 wrote: Sat May 13, 2023 7:06 am These services are all based on the backbone of using the lowest, cheapest, and resulting bottom of the barrel trained "doctors". They're just peddling undertrained nurse practioners, physician assistants etc. You know it's a charade when you see the title DNP AAFP BLS.....

Is it convenient? Sure. But what's the quality?
Way to disparage two entire professions.
The medical "profession" is not good at taking constructive suggestions, and that "profession" has driven the state of health care to where it is today.

My medical "insurance" is through Kaiser Permanente in California, yet it seems that most of the few times when I need "health care", Kaiser Permanente has no issue with pawning me off to a PA or to an outside practice. I was recently sent by Kaiser to an outside practice for an annual check of a previously significant issue: when I arrived, I turned around and walked out because the practice looked like it was from a third world nation and the waiting room was filthy.

In my books, Kaiser Permanente went from a 5 Star rating before ACA and COVID, and once those events hit, I would not even rate KP 1 Star. It seems the greed of the "professionals" that share in owning KP have just one thing in mind, and it's not quality health care.

Maybe these "professionals" need to take a close look at their industry and make some changes before AI puts them out of business.

Your use of quotes is curious. I hope you place at least as much blame on our current healthcare system on the multibillion dollar industries involved as you do the people who dedicated 7-10 years of their lives to take care of you
ScubaHogg
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Re: Amazon One Medical offer

Post by ScubaHogg »

We used OneMedical for a couple years a decade ago (before they were acquired by Amazon). Fwiw with my dated information we were very happy with the service
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boglegirl
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Re: Amazon One Medical offer

Post by boglegirl »

Theseus wrote: Sat May 13, 2023 3:35 pm ...
But I would not like an NP when I specifically want a certified doctor. However I don't know how this is different from the traditional places that are pushing NPs. I had an appointment with an Ortho (hand & shoulder specialist) for a sever pain my my hand. I assumed (wrongly :oops: ) that I will see the doctor. Well a nurse comes in - I was not on doctor's schedule....
I had a similar experience when I went to a back specialist in a well respected physician group. I was surprised that my visit turned out to be not with the doctor, but with a paraprofessional. It turned out this was standard procedure for the office; new patients had to go through a "gatekeeping" process. In my case it turned out fine - I'm sorry you were misdiagnosed :(
VT03008
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Re: Amazon One Medical offer

Post by VT03008 »

Theseus wrote: Sat May 13, 2023 3:35 pm OP Here.

Thank you all for fairly informative replies. I was aware of privacy issue in their disclaimer and NPR story. But I am not concerned about that.

But I would not like an NP when I specifically want a certified doctor. However I don't know how this is different from the traditional places that are pushing NPs. I had an appointment with an Ortho (hand & shoulder specialist) for a sever pain my my hand. I assumed (wrongly :oops: ) that I will see the doctor. Well a nurse comes in - I was not on doctor's schedule. I should have made a stink - but Ortho is a friend of a family member and it would have been more drama. While he is rated consistently top 10 Ortho in his area, there was a sort of a misdiagnosis (not relevant to the discussion here) which months later a second opinion from another hand specialist confirmed.

Most of my friends are doctors of some speciality. I believe they are all very competent, and trying to do right thing for their patients. But every discussion usually is about money and reimbursement.So pushing NPs, other cash business etc is a clear motivation. What I am trying to say is that NP instead of a doctor is not a problem with just One Medical. This is becoming industry problem. I have to find a way to deal with it whether it is traditional medicine of something like amazon/one medical.
My parents made a switch to a concierge style primary care office a couple years ago for this very reason. It wasn't so much the idea of a mid-level that bothered them but that it was a new provider almost every time and they were simply patient # 1234.

While they balked at the membership price at first they have been very pleased. Same or next day (non rushed) appts with same MD each time and they can call the office and pretty quickly get the doc on the phone for any follow-up up questions or concerns. He is also very candid with them in terms of what specialists they should see and which they should avoid. They don't really have many issue fortunately but I can see the value of such an office increasing exponentially as one develops more or more complex issues.
boglegirl
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Re: Amazon One Medical offer

Post by boglegirl »

safari wrote: Sat May 13, 2023 9:17 am ...
I also go to urgent care whenever I need to see a doctor and can't wait for an appointment. It costs less than Amazon One charges per visit...
Ugh, my insurance company charges $125 co-pay for any physician group the bills as "urgent care". (versus a more typical $20 co-insurance for a standard office visit). Still, I was happy to see a doctor with no appointment and only about a 45-minute wait - got a preliminary diagnosis and he ordered appropriate tests and gave me a referral to a specialist. Worth the $125, I guess!
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CardinalRule
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Re: Amazon One Medical offer

Post by CardinalRule »

Any recent experiences, a year later?

I received an email promotion today reminding me of the availability of One Medical for $9 a month (Prime members):

* 024/7 on-demand care via Video Chat or TreatMe Now
* Secure messaging with a provider
* In-app health records and care plans
* Convenient prescription refill and renewal requests[/list]

I've only just started to research this; so far I have found that my wife's employer health care plan (which I'm covered under) is accepted by One Medical. I (knock on wood) don't have to go to the doctor very often.

Anyway, curious if any Prime members have found this offering worthwhile.
Last edited by CardinalRule on Mon May 13, 2024 7:39 pm, edited 1 time in total.
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