Concierge medicine Worth It????

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2pedals
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Re: Concierge medicine Worth It????

Post by 2pedals » Sat Jun 16, 2018 7:56 pm

ResearchMed wrote:
Sat Jun 16, 2018 4:12 pm
dm200 wrote:
Sat Jun 16, 2018 3:36 pm
2pedals wrote:
Sat Jun 16, 2018 3:33 pm
dm200 wrote:
Sat Jun 16, 2018 3:15 pm
Seems to me that the added $100/month or so is not really that much more. Also seems puzzling how these physicians can net as much when cutting back on patients.
No Kaiser plan is not offered in my area and by my employer. My employer offers Blue Cross Blue Shield PPO plans and Group Health at a much higher premium. If I retire and move into an area with a strong Kaiser presents I will keep your experience in mind.
I don't know how concierge medicine provider manages to provide this service for the amount I pay per month.
What is the "Group Health" specific plan? Is it an HMO like Kaiser?
Years ago, when I was living in Seattle, we had Group Health (a coop), which I think may have been taken over by Kaiser?

It was phenomenal.i
I had expected them to turn away anything other than really serious problems, to save money.
But as it turned out, and especially with little children, they covered even OTC meds, by handing them right to you (patient or parent), with the logic that it was less expensive to prevent than to wait for, say, a cold, to become something more serious.

And when I had a life-threatening problem out of the blue, they didn't seem to hold back on any specialists, or keeping me in hospital, etc., until they had at least a handle on what was happening.
(To this day, major medical centers elsewhere have never dealt with the same problem any better than Group Health, where it was first diagnosed.)

Group Health sure seemed like what "concierge medicine" is now...

But when we moved, the local (elsewhere) medical "coop" (one presumably affiliated with Group Health??) would make one wait *weeks* for anything at all.
Totally different.
We were "outta there" fast!

RM
I need to correct myself. My employer offers Kaiser (formerly known as Group Health), I was unaware of the buyout. Personally I do not know anybody that signed up because of it is such an expensive option, more than 1,000/mo. above my current option.

HIinvestor
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Re: Concierge medicine Worth It????

Post by HIinvestor » Sat Jun 16, 2018 8:20 pm

I recently turned 60. I mostly see my internist as scheduled—every 6 months. I have a chronic progressive lung condition and see my local lung doc also every 6 months.

My old internist (whom I’ve seen for over 30 years) was 68 and having his own health issues, so I asked my lung doc for a referral to an internist and he referred me to his internist, with whom he works very well and is in the same electronic medical records system as him.

The new internist shares call with a dozen other internists and I can contact her by email. I have both email and cell number of my lung doctor. The internist recommended a dexascan, did all the paperwork and shared the results with me on the electronic health records system they have within about a day.

I have also seen other lung specialists in several medical centers. All the doctors timely respond to e-mails. I honestly can’t see what a concierge would add. When I need to see an MD urgently, they will fit me into the schedule or refer to urgent care.

I’m sorry for the huge paperwork burden but can’t see what I as a patient can do to lessen it. My spouse is 76. He also only sees his internist 2x/year or so and is fit in as needed for more urgent visits. I don’t see what concierge care would add for him either.

When I had numerous unresolved questions in 2016, my lung specialist in CO had me spend 8 days at his medical center and see a bunch of specialists as an outpatient and coordinated all the tests and interpreted the results so they made sense to me and H. It was invaluable and what I imagine concierge medicine would be. I didn’t pay extra but all providers were participating and preferred by my BCBS.

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dm200
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Re: Concierge medicine Worth It????

Post by dm200 » Sun Jun 17, 2018 9:22 am

CedarWaxWing wrote:
Sat Mar 12, 2016 4:10 pm
Rexindex wrote:To clarify, my PCP is 68, in great shape and plans on practicing another 5 or so years.
He does not need the money but I am absolutely sure the quality of life for him will be much improved. HE has cited numerous times he is tired of getting 5 minutes to talk about 2 problems when the patient has 5 problems.
It is a tough choice because he is a great doc but since we are relatively healthy it is hard to justify the cost. At our age we are interested in giving it a year and seeing what the benefits are.
This is one of the problems with concierge medicine... the healthy paitients will pay much more than they would otherwise.... and it would presumably be good for both those patients and that md to continue the doctor patient relationship... but the law does not allow to give a different annual fee to you (or me) simply because he knows you will not need or use the "extra service" such as 24 hour access, or long appointment times, etc.
(Although for a pt who is not able to afford the fee he may be able to waive that fee totally or in part for economic distress.)
m
Couldn't there be two "concierge" fees - one for up to X hours of service and another for more than X?

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dm200
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Re: Concierge medicine Worth It????

Post by dm200 » Sun Jun 17, 2018 9:26 am

I need to correct myself. My employer offers Kaiser (formerly known as Group Health), I was unaware of the buyout. Personally I do not know anybody that signed up because of it is such an expensive option, more than 1,000/mo. above my current option.
Strange! In recent years, Kaiser coverage through employers tends to be no higher than "regular" type coverage and is often lower.

I would watch it and see what happens in the future. Maybe some kind of transition issue.

vested1
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Re: Concierge medicine Worth It????

Post by vested1 » Sun Jun 17, 2018 9:59 am

ResearchMed wrote:
Sat Jun 16, 2018 12:49 pm
vested1 wrote:
Sat Jun 16, 2018 12:01 pm
dm200 wrote:
Sat Jun 16, 2018 10:37 am


One, big (in my opinion) challenge of good health and healthcare is proper compensation for providers. Such "providers" almost exclusively get paid for "doing things" - and not for keeping patients healthy. The "least profitable" (financially) patients are the healthy ones.

Pills are covered by insurance - as are office visits to monitor them. Insurance does not pay for broccoli and blueberries.
As evidenced by the methods of my newest PCP, whose partner is on MDVip, while he is not. He compensates by trying to up-sell me regular testosterone implants, which I don't need and which are very expensive. He also called for a blood test, which I thought normal since I get tested every year. I found it odd that they took my blood in his office however, as it is usually done at one of several local clinics. I finally understood when I got the bill for over $5,000 after he sent my blood to a private clinic in Boston (I live on the west coast). The brochure that came with the bill was perhaps 20 pages long with glossy pictures and a detailed analysis of my blood, with a recommendation that I join their program for additional benefits.

Not only did I decline, but I didn't pay the bill, which had no consequence as this is the normal reaction according to another patient I know who also didn't pay the nasty surprise he got in his mailbox, and from the receptionist who verified that fact. I offered to pay the contracted price of a blood test, but it was written off.
Yikes. :annoyed

Are you now with another PCP?

Separate question: How does it work for a regular PCP to "partner" with one on MDVip?

RM
I am shopping for another PCP because of the up-selling mentioned above. I get my prescriptions via CVS mail, which calls the doctor when a renewal is needed. He has refused to refill the prescriptions unless I visit the office. As for his partner being on MDVip and him not being on it, I would assume that those other patients that my PCP ropes into the up-sell more than make up for what is lost in concierge charges.

I did get a pleasant surprise recently however. My wife's insurance covers us both beyond Medicare as supplemental and provides excellent coverage, with no need for anything else besides Medicare parts A and B. We were paying $181 a month for her insurance and I don't pay for my own retiree insurance as it is four times expensive with poor coverage. I have been on Medicare for a year and my wife is starting her Medicare in July. We were informed by her insurance that her coverage continues (other than dental and vision which I need to address), but that the cost drops to $100 a month to cover us both indefinitely. She has a medication that retails for $1,200 a week, but her insurance makes it so our co-pay is $10 every 90 days.

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dm200
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Re: Concierge medicine Worth It????

Post by dm200 » Sun Jun 17, 2018 10:13 am

I did get a pleasant surprise recently however. My wife's insurance covers us both beyond Medicare as supplemental and provides excellent coverage, with no need for anything else besides Medicare parts A and B. We were paying $181 a month for her insurance and I don't pay for my own retiree insurance as it is four times expensive with poor coverage. I have been on Medicare for a year and my wife is starting her Medicare in July. We were informed by her insurance that her coverage continues (other than dental and vision which I need to address), but that the cost drops to $100 a month to cover us both indefinitely. She has a medication that retails for $1,200 a week, but her insurance makes it so our co-pay is $10 every 90 days.
Good luck! If this is a private employer, there is a risk that they could terminate the coverage for retirees. That happened to a friend of ours who retired from a megacorp after over 30 years.

ResearchMed
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Re: Concierge medicine Worth It????

Post by ResearchMed » Sun Jun 17, 2018 10:56 am

dm200 wrote:
Sun Jun 17, 2018 10:13 am
I did get a pleasant surprise recently however. My wife's insurance covers us both beyond Medicare as supplemental and provides excellent coverage, with no need for anything else besides Medicare parts A and B. We were paying $181 a month for her insurance and I don't pay for my own retiree insurance as it is four times expensive with poor coverage. I have been on Medicare for a year and my wife is starting her Medicare in July. We were informed by her insurance that her coverage continues (other than dental and vision which I need to address), but that the cost drops to $100 a month to cover us both indefinitely. She has a medication that retails for $1,200 a week, but her insurance makes it so our co-pay is $10 every 90 days.
Good luck! If this is a private employer, there is a risk that they could terminate the coverage for retirees. That happened to a friend of ours who retired from a megacorp after over 30 years.
This is always a concern.

DH will retire very belatedly, so we have been carefully monitoring all retiree-related issues.
A few years ago, we were notified that we'll be grandfathered in to the current (and excellent) retiree health benefits, whenever he retires.
They now have different "tiers" of retiree (and other) benefits for those much younger/with fewer years of employment.

This is a very good employer, with especially strong long-term finances, so it's unlikely to become a problem for them, or at least not in our lifetimes.
However, all such benefits may continue to get watered down for the newest employees, as seems to be happening in general everywhere, unfortunately.
It's all quite different from "what we grew up with", etc.

RM
This signature is a placebo. You are in the control group.

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Alexa9
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Re: Concierge medicine Worth It????

Post by Alexa9 » Sun Jun 17, 2018 11:02 am

I think it might be worth it if you have complicated health issues and need more attention from your doctor. Primary Care Doctors struggle to make a good salary and this is a legitimate way of running a business. The insurance system is the problem, not the doctors.

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dm200
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Re: Concierge medicine Worth It????

Post by dm200 » Sun Jun 17, 2018 2:09 pm

Alexa9 wrote:
Sun Jun 17, 2018 11:02 am
I think it might be worth it if you have complicated health issues and need more attention from your doctor. Primary Care Doctors struggle to make a good salary and this is a legitimate way of running a business. The insurance system is the problem, not the doctors.
It can also be more "subjective" than "objective" for some. These folks may place a high value on being able to contact the doctor directly evenings or weekends - even if they rarely or never actually do so.

HIinvestor
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Re: Concierge medicine Worth It????

Post by HIinvestor » Sun Jun 17, 2018 8:42 pm

Since I have several of my MDs cell numbers and emails, I COULD contact them on nights or weekends but have only sent a text once early Saturday morning just before leaving on a trip, upon realizing I was low on one of my Rx and would run out while traveling. He gave me a new Rx but did razz me about sending it so early on a Saturday and just before leaving.

Have rarely had to reach most MDs. It IS nice to be able to, especially when I get a nasty infection that needs immediate attention while traveling.

I have never been a concierge patient but have gotten great service—have been very fortunate. I would be willing to pay my doctors more as a retainer if that is what is required but have never been asked.

mac808
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Re: Concierge medicine Worth It????

Post by mac808 » Sun Jun 17, 2018 10:49 pm

HIinvestor wrote:
Sun Jun 17, 2018 8:42 pm
Since I have several of my MDs cell numbers and emails, I COULD contact them on nights or weekends but have only sent a text once early Saturday morning just before leaving on a trip, upon realizing I was low on one of my Rx and would run out while traveling. He gave me a new Rx but did razz me about sending it so early on a Saturday and just before leaving.

Have rarely had to reach most MDs. It IS nice to be able to, especially when I get a nasty infection that needs immediate attention while traveling.

I have never been a concierge patient but have gotten great service—have been very fortunate. I would be willing to pay my doctors more as a retainer if that is what is required but have never been asked.
HIinvestor, I'm glad you've gotten great care, but I'll just point out that what you're describing (email and text access direct to the MD) is not the typical experience most insured patients have. If it were, I'm guessing this thread wouldn't exist. It sounds like you're getting first class treatment for the price of a coach ticket. :wink:

HIinvestor
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Re: Concierge medicine Worth It????

Post by HIinvestor » Mon Jun 18, 2018 4:41 am

I agree that I have gotten exceptional treatment but also have to say I’m a very good patient in that I follow our agreed upon treatment regimen and let them know promptly if something is amiss. I also admit I’ve had to fire quite a few doctors along to way to get the exceptional team I have and that I have a different relationship with them than many patients.

I also don’t abuse the email and cell phone access but treasure that as a sign of mutual respect; they also have my email and cell phone number and sometimes call me for assistance. I also share info with my docs and pharmacist that is current and relevant to their practice.

Actually, everyone who is a patient at the medical center and on the online portal as two of my MDs can send messages to them via that system. The MDs at UCSF and Stanford and Nationsl Jewish also have electronic systems which allow any patient to send messages to his/her MDs as well. This system also allows patients to ask for more Rx and refills. I try to use these systems first.

I am very concerned about the availability and quality of care and availability of primary care MDs, as well as specialists. It is a huge issue and has caused several friends to switch from BCBS (blue cross blue shield) to HMO (Kaiser) or try concierge medicine because they like their primary care MD and wanted to keep her but they had such trouble finding that MD. It is very challenging to find and keep good doctors.

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Re: Concierge medicine Worth It????

Post by vested1 » Mon Jun 18, 2018 10:03 am

dm200 wrote:
Sun Jun 17, 2018 10:13 am
I did get a pleasant surprise recently however. My wife's insurance covers us both beyond Medicare as supplemental and provides excellent coverage, with no need for anything else besides Medicare parts A and B. We were paying $181 a month for her insurance and I don't pay for my own retiree insurance as it is four times expensive with poor coverage. I have been on Medicare for a year and my wife is starting her Medicare in July. We were informed by her insurance that her coverage continues (other than dental and vision which I need to address), but that the cost drops to $100 a month to cover us both indefinitely. She has a medication that retails for $1,200 a week, but her insurance makes it so our co-pay is $10 every 90 days.
Good luck! If this is a private employer, there is a risk that they could terminate the coverage for retirees. That happened to a friend of ours who retired from a megacorp after over 30 years.
if we were depending on my megacorp retiree benefits we would be in a world of hurt. Her pension and retiree benefits are very well funded and connected to a utility which everyone needs with zero competition. If her insurance ever becomes unaffordable or is cancelled we are held harmless because her coverage is better than that required by Medicare, so we are not penalized if we have to transfer coverage at a later date. If that ever comes to pass, which I doubt, we will be in the same leaky boat with everyone else.

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dm200
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Re: Concierge medicine Worth It????

Post by dm200 » Mon Jun 18, 2018 10:14 am

HIinvestor wrote:
Mon Jun 18, 2018 4:41 am
I agree that I have gotten exceptional treatment but also have to say I’m a very good patient in that I follow our agreed upon treatment regimen and let them know promptly if something is amiss. I also admit I’ve had to fire quite a few doctors along to way to get the exceptional team I have and that I have a different relationship with them than many patients.
I also don’t abuse the email and cell phone access but treasure that as a sign of mutual respect; they also have my email and cell phone number and sometimes call me for assistance. I also share info with my docs and pharmacist that is current and relevant to their practice.
Actually, everyone who is a patient at the medical center and on the online portal as two of my MDs can send messages to them via that system. The MDs at UCSF and Stanford and Nationsl Jewish also have electronic systems which allow any patient to send messages to his/her MDs as well. This system also allows patients to ask for more Rx and refills. I try to use these systems first.
I am very concerned about the availability and quality of care and availability of primary care MDs, as well as specialists. It is a huge issue and has caused several friends to switch from BCBS (blue cross blue shield) to HMO (Kaiser) or try concierge medicine because they like their primary care MD and wanted to keep her but they had such trouble finding that MD. It is very challenging to find and keep good doctors.
As I get older - and have more "issues" - I have become more convinced (from experience) that [in my Kaiser plan] being a "good patient" reaps better and more attentive care from most Physicians. My PCP is especially responsive and, when discussion various matters, usually now asks me, "What do you think?" It seems, as well, that she does not seem at all rushed when I have appointments with her - even though Kaiser schedules PCPs at 3 patients an hour over the full day.

I do not always agree with her - BUT when I do not - I clearly state why and often cite a credible reference. Last year - she wanted me to go on Lipitor - saying I have a 20% risk of heart attack (some automated prompt she got when she pulled up my records). I "pushed back" and actually found a Kaiser study that found (at least as I read it) this calculation was overstated by a factor of ten.

Not all Physicians want such "involved" patients. I am fortunate.

2pedals
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Re: Concierge medicine Worth It????

Post by 2pedals » Mon Jun 18, 2018 10:52 am

dm200 wrote:
Sun Jun 17, 2018 9:26 am
I need to correct myself. My employer offers Kaiser (formerly known as Group Health), I was unaware of the buyout. Personally I do not know anybody that signed up because of it is such an expensive option, more than 1,000/mo. above my current option.
Strange! In recent years, Kaiser coverage through employers tends to be no higher than "regular" type coverage and is often lower.

I would watch it and see what happens in the future. Maybe some kind of transition issue.
I do not understand my megacorp employer costs. They offer self-insured plans and subcontract to BCBS the administration of the megacorp plan. I suspect the HMO option is much more expensive because it is not self-insured. I would not compare my plan with "regular" type coverage because it is structured differently.

HIinvestor
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Re: Concierge medicine Worth It????

Post by HIinvestor » Mon Jun 18, 2018 12:36 pm

I was surprised my newest internist gave me her personal cell number (which I have never used). It is nice to have cell numbers just in case there is ever an urgent need to reach the MDs.

On the other hand some docs have you reach out to their answering service or advise you on their answering machine to go to the emergency room. I have never been an an emergency room so far in my life. I have been to urgent care and a orthopedic walk in clinic once each with a broken bone (same bone :-().

I routinely have one hour visits with my nationally renown lung specialists (but I pay for the transportation costs). They do answer emails as well. I found their emails online. All my visits with MD or APRN, general or specialist has same $15 copay. I have no deductible, no lifetime max benefit and a low 4 figure annual cap on out of pocket copays including Rx meds.

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Re: Concierge medicine Worth It????

Post by drawpoker » Tue Jul 10, 2018 7:20 pm

drawpoker wrote:
Sat Jun 16, 2018 1:18 pm
dm200 wrote:
Sat Jun 16, 2018 12:29 pm
I wonder if anyone who has signed up for "concierge medicine" has been able to offset any of the annual fee with other savings?
.... I might benefit.....Maryland is one of the states that removed all means testing for food stamps.....people over 60 get way more..that age bracket is allowed medical deductions that the younger folks don't get. ......
according to my caseworker, if my monthly medical costs suddenly jump by $137.50 (one-twelfth of $1,650), my FS allotment will go up by $62, from $120 to $182.

But .......not certain if this concierge fee actually is a "qualified medical expense" will check with state......problem seems to be it is not technically health insurance....or a co-pay bill for a medical exam or procedure. It is not anywhere on their list of allowable deductions.....hinted that the bureaucrats could take the position that this is a discretionary expense, something that is not necessary, and people can just switch doctors to avoid it.......Will post back went I get the answer.
As promised, re-posting again. Good news, got my answer, yes, The Old Line State has given official stamp of approval.

So, just when I started feeling a whole lot better about this drastic change from my doc, here comes today's mail. Which pisses me supremely off again.
Letter was to invite me to this special informational patients meeting (90 minutes) that the doc has called for later this month. What pissed me off is the location, am cordially invited, on such and such date and time, to the XXX Yacht & Country Club to attend. They even added (in bold face) that Complimentary Valet Parking was available! Really? No kidding?

Maybe I am over-reacting (?) But I can't help feel this is over the top. Maybe unintended. But the message I am inferring is that, yup, concierge medicine is for the upper crust, alright. The haves and the have-nots. She could just as easily booked one of the very large meeting rooms available at the public library, fire hall, high school. Esp. during the slow summer months, any of them always have reservations open for most any days or evenings.

But, no, the swanky (and super high membership dues) local yacht club is picked.

btw, when I called the # given for R.S.V.P., it was the Fat Cats in Palm Beach (MDVIP office) I said the invitation said nothing about a meal, heavy hors d'oeuvres, light refreshments, not a word. Is she going to feed us? Must be, why else hold it at the country club?
The rep was completely flummoxed at this, had no idea, said if she could put me on hold for a moment, would find out.
5 minutes later she came back, still dunno, promised to call me back when she found out.
Last edited by drawpoker on Tue Jul 10, 2018 7:30 pm, edited 1 time in total.

toofache32
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Re: Concierge medicine Worth It????

Post by toofache32 » Tue Jul 10, 2018 7:29 pm

This phenomenon has been discussed on doctor forums I participate in. Is it better to have a BMW or an old Honda parked in the doctor's spot at the office? There are patients who believe a Honda means the doctor is not very successful while others like the idea that the doctor drives the same car they do. Then there are patients who think a BMW must mean the doctor is a crook, while others believe he is successful and must be providing good care if this many patients keep coming back.

I'm sure they could help you find an unsuccessful doctor.

drawpoker
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Re: Concierge medicine Worth It????

Post by drawpoker » Tue Jul 10, 2018 7:32 pm

Yeah, maybe
Or, maybe it is just more convenient. She can step off the golf course and go directly to the meeting. :happy

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dm200
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Re: Concierge medicine Worth It????

Post by dm200 » Wed Jul 11, 2018 8:42 am

drawpoker wrote:
Tue Jul 10, 2018 7:20 pm
drawpoker wrote:
Sat Jun 16, 2018 1:18 pm
dm200 wrote:
Sat Jun 16, 2018 12:29 pm
I wonder if anyone who has signed up for "concierge medicine" has been able to offset any of the annual fee with other savings?
.... I might benefit.....Maryland is one of the states that removed all means testing for food stamps.....people over 60 get way more..that age bracket is allowed medical deductions that the younger folks don't get. ......
according to my caseworker, if my monthly medical costs suddenly jump by $137.50 (one-twelfth of $1,650), my FS allotment will go up by $62, from $120 to $182.
But .......not certain if this concierge fee actually is a "qualified medical expense" will check with state......problem seems to be it is not technically health insurance....or a co-pay bill for a medical exam or procedure. It is not anywhere on their list of allowable deductions.....hinted that the bureaucrats could take the position that this is a discretionary expense, something that is not necessary, and people can just switch doctors to avoid it.......Will post back went I get the answer.
As promised, re-posting again. Good news, got my answer, yes, The Old Line State has given official stamp of approval.
So, just when I started feeling a whole lot better about this drastic change from my doc, here comes today's mail. Which pisses me supremely off again.
Letter was to invite me to this special informational patients meeting (90 minutes) that the doc has called for later this month. What pissed me off is the location, am cordially invited, on such and such date and time, to the XXX Yacht & Country Club to attend. They even added (in bold face) that Complimentary Valet Parking was available! Really? No kidding?
Maybe I am over-reacting (?) But I can't help feel this is over the top. Maybe unintended. But the message I am inferring is that, yup, concierge medicine is for the upper crust, alright. The haves and the have-nots. She could just as easily booked one of the very large meeting rooms available at the public library, fire hall, high school. Esp. during the slow summer months, any of them always have reservations open for most any days or evenings.
But, no, the swanky (and super high membership dues) local yacht club is picked.
btw, when I called the # given for R.S.V.P., it was the Fat Cats in Palm Beach (MDVIP office) I said the invitation said nothing about a meal, heavy hors d'oeuvres, light refreshments, not a word. Is she going to feed us? Must be, why else hold it at the country club?
The rep was completely flummoxed at this, had no idea, said if she could put me on hold for a moment, would find out.
5 minutes later she came back, still dunno, promised to call me back when she found out.
Very "interesting" - sounds like one of those pitches for timeshares or high fee investment advisors! Maybe this "upper crust" have different medical conditions than the "riff raff". ??

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dm200
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Re: Concierge medicine Worth It????

Post by dm200 » Wed Jul 11, 2018 8:45 am

toofache32 wrote:
Tue Jul 10, 2018 7:29 pm
This phenomenon has been discussed on doctor forums I participate in. Is it better to have a BMW or an old Honda parked in the doctor's spot at the office? There are patients who believe a Honda means the doctor is not very successful while others like the idea that the doctor drives the same car they do. Then there are patients who think a BMW must mean the doctor is a crook, while others believe he is successful and must be providing good care if this many patients keep coming back.
I'm sure they could help you find an unsuccessful doctor.
Today, since doctors don't make "housecalls" - hard to know what car a doctor drives. I personally know several doctors that drive just regular cars - like we do.

Today, as well, driving a hybrid (like a Pruis) could very well appeal to a certain segment as well.

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El Greco
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Re: Concierge medicine Worth It????

Post by El Greco » Wed Jul 11, 2018 4:02 pm

toofache32 wrote:
Tue Jul 10, 2018 7:29 pm
This phenomenon has been discussed on doctor forums I participate in. Is it better to have a BMW or an old Honda parked in the doctor's spot at the office? There are patients who believe a Honda means the doctor is not very successful while others like the idea that the doctor drives the same car they do. Then there are patients who think a BMW must mean the doctor is a crook, while others believe he is successful and must be providing good care if this many patients keep coming back.

I'm sure they could help you find an unsuccessful doctor.
My wonderful internist, who retired 2 years ago, had two old Hondas parked in his driveway. You see, his office was attached to his home. He never rushed me, gave great advice and treatment, and wasn't greedy. He also kept current and was always attending seminars. I would usually research any possible condition I might have before seeing him and I was always amazed at his depth of knowledge on virtually every medical topic. Since his retirement, my wife and I have searched high and low for a suitable replacement, without success. He was the best doctor we ever had, and I'm fairly certain the best doctor we will ever have. Kind, knowledgeable, down to earth,not a trace of arrogance, and I'm pretty sure a closet Boglehead. If a new BMW in the driveway is a measure of "success", I guess I'll go with the "unsuccessful" doctor.

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Re: Concierge medicine Worth It????

Post by dm200 » Wed Jul 11, 2018 4:30 pm

El Greco wrote:
Wed Jul 11, 2018 4:02 pm
toofache32 wrote:
Tue Jul 10, 2018 7:29 pm
This phenomenon has been discussed on doctor forums I participate in. Is it better to have a BMW or an old Honda parked in the doctor's spot at the office? There are patients who believe a Honda means the doctor is not very successful while others like the idea that the doctor drives the same car they do. Then there are patients who think a BMW must mean the doctor is a crook, while others believe he is successful and must be providing good care if this many patients keep coming back.
I'm sure they could help you find an unsuccessful doctor.
My wonderful internist, who retired 2 years ago, had two old Hondas parked in his driveway. You see, his office was attached to his home. He never rushed me, gave great advice and treatment, and wasn't greedy. He also kept current and was always attending seminars. I would usually research any possible condition I might have before seeing him and I was always amazed at his depth of knowledge on virtually every medical topic. Since his retirement, my wife and I have searched high and low for a suitable replacement, without success. He was the best doctor we ever had, and I'm fairly certain the best doctor we will ever have. Kind, knowledgeable, down to earth,not a trace of arrogance, and I'm pretty sure a closet Boglehead. If a new BMW in the driveway is a measure of "success", I guess I'll go with the "unsuccessful" doctor.
Good luck! You may have to find a good one in the current "model" of medical practice.

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Re: Concierge medicine Worth It????

Post by toofache32 » Wed Jul 11, 2018 8:12 pm

El Greco wrote:
Wed Jul 11, 2018 4:02 pm
toofache32 wrote:
Tue Jul 10, 2018 7:29 pm
This phenomenon has been discussed on doctor forums I participate in. Is it better to have a BMW or an old Honda parked in the doctor's spot at the office? There are patients who believe a Honda means the doctor is not very successful while others like the idea that the doctor drives the same car they do. Then there are patients who think a BMW must mean the doctor is a crook, while others believe he is successful and must be providing good care if this many patients keep coming back.

I'm sure they could help you find an unsuccessful doctor.
My wonderful internist, who retired 2 years ago, had two old Hondas parked in his driveway. You see, his office was attached to his home. He never rushed me, gave great advice and treatment, and wasn't greedy. He also kept current and was always attending seminars. I would usually research any possible condition I might have before seeing him and I was always amazed at his depth of knowledge on virtually every medical topic. Since his retirement, my wife and I have searched high and low for a suitable replacement, without success. He was the best doctor we ever had, and I'm fairly certain the best doctor we will ever have. Kind, knowledgeable, down to earth,not a trace of arrogance, and I'm pretty sure a closet Boglehead. If a new BMW in the driveway is a measure of "success", I guess I'll go with the "unsuccessful" doctor.
Curious how this opinion on greed was determined. Most people will look for ways to improve their employment situation. I guess everyone here asking how to minimize tax payments are also greedy.

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Re: Concierge medicine Worth It????

Post by El Greco » Wed Jul 11, 2018 11:20 pm

toofache32 wrote:
Wed Jul 11, 2018 8:12 pm
El Greco wrote:
Wed Jul 11, 2018 4:02 pm
toofache32 wrote:
Tue Jul 10, 2018 7:29 pm
This phenomenon has been discussed on doctor forums I participate in. Is it better to have a BMW or an old Honda parked in the doctor's spot at the office? There are patients who believe a Honda means the doctor is not very successful while others like the idea that the doctor drives the same car they do. Then there are patients who think a BMW must mean the doctor is a crook, while others believe he is successful and must be providing good care if this many patients keep coming back.

I'm sure they could help you find an unsuccessful doctor.
My wonderful internist, who retired 2 years ago, had two old Hondas parked in his driveway. You see, his office was attached to his home. He never rushed me, gave great advice and treatment, and wasn't greedy. He also kept current and was always attending seminars. I would usually research any possible condition I might have before seeing him and I was always amazed at his depth of knowledge on virtually every medical topic. Since his retirement, my wife and I have searched high and low for a suitable replacement, without success. He was the best doctor we ever had, and I'm fairly certain the best doctor we will ever have. Kind, knowledgeable, down to earth,not a trace of arrogance, and I'm pretty sure a closet Boglehead. If a new BMW in the driveway is a measure of "success", I guess I'll go with the "unsuccessful" doctor.
Curious how this opinion on greed was determined. Most people will look for ways to improve their employment situation. I guess everyone here asking how to minimize tax payments are also greedy.
I wasn't implying that all doctors are greedy, but some certainly are. Sorry toofache if I hit a nerve.

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Re: Concierge medicine Worth It????

Post by toofache32 » Wed Jul 11, 2018 11:24 pm

Of course there are greedy doctors, accountants, attorneys, plumbers, real estate agents, and everyone else. I was just curious how you came to this realization about a specific person from the outside. Making such a statement is often an emotional view not based on facts or reality.

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Re: Concierge medicine Worth It????

Post by dm200 » Thu Jul 12, 2018 12:05 pm

toofache32 wrote:
Wed Jul 11, 2018 11:24 pm
Of course there are greedy doctors, accountants, attorneys, plumbers, real estate agents, and everyone else. I was just curious how you came to this realization about a specific person from the outside. Making such a statement is often an emotional view not based on facts or reality.
Just about any type of "profession" faces the need to generate income (usually from 'doing' things) vs the benefit/harm to the customer/client. Plumbers make more money, usually, by selling a new toilet - and installing it. Physicians usually only earn money by "doing things" at patient visits. In past lives, my "job" was to increase use of computer services by customers - even if not technically necessary or in the customer's best financial interst.

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Re: Concierge medicine Worth It????

Post by Miriam2 » Thu Jul 12, 2018 6:55 pm

drawpoker wrote: So, just when I started feeling a whole lot better about this drastic change from my doc, here comes today's mail. . . . Letter was to invite me to this special informational patients meeting (90 minutes) that the doc has called for later this month. What pissed me off is the location, am cordially invited, on such and such date and time, to the XXX Yacht & Country Club to attend. They even added (in bold face) that Complimentary Valet Parking was available! . . .
Drawpoker, I didn't quite understand this. Do you mean your doctor, who recently went with concierge with MDVIP, has scheduled a meeting with all her patients together, presumably in a large room, to give them information on her new concierge system, and that the meeting place is a Yacht & Country Club with complimentary valet parking? Is this in addition to - or rather than - sending the information to the patients with a letter and the name of a person in the doctor's office to contact if you have questions?

Was this information meeting arranged by MDVIP or by your doctor?

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Re: Concierge medicine Worth It????

Post by dm200 » Thu Jul 12, 2018 7:39 pm

Miriam2 wrote:
Thu Jul 12, 2018 6:55 pm
drawpoker wrote: So, just when I started feeling a whole lot better about this drastic change from my doc, here comes today's mail. . . . Letter was to invite me to this special informational patients meeting (90 minutes) that the doc has called for later this month. What pissed me off is the location, am cordially invited, on such and such date and time, to the XXX Yacht & Country Club to attend. They even added (in bold face) that Complimentary Valet Parking was available! . . .
Drawpoker, I didn't quite understand this. Do you mean your doctor, who recently went with concierge with MDVIP, has scheduled a meeting with all her patients together, presumably in a large room, to give them information on her new concierge system, and that the meeting place is a Yacht & Country Club with complimentary valet parking? Is this in addition to - or rather than - sending the information to the patients with a letter and the name of a person in the doctor's office to contact if you have questions?
Was this information meeting arranged by MDVIP or by your doctor?
I had not heard of this. I would go - to learn about this "approach".

Maybe you could go and give us a report? I am very curious.

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Re: Concierge medicine Worth It????

Post by drawpoker » Thu Jul 12, 2018 10:10 pm

Miriam2 wrote:
Thu Jul 12, 2018 6:55 pm

Drawpoker, I didn't quite understand this.

Me, neither!


Do you mean your doctor, who recently went with concierge with MDVIP, has scheduled a meeting with all her patients together, presumably in a large room, to give them information on her new concierge system, and that the meeting place is a Yacht & Country Club with complimentary valet parking?

Exactly. Except not sure about the part "to give them information" as you say on new system. Cynic that I am, I think she hasn't gotten a rousing response to the initial announcement (it has been over a month now) and this so-called "informational meeting" for patients is going to turn into a slick sales pitch to sign up.



Is this in addition to - or rather than - sending the information to the patients with a letter and the name of a person in the doctor's office to contact if you have questions?

Definitely in the "addition to" category. Also, btw, from the git-go, the contact person and # for information is most definitely NOT someone in the doc's office - it is area code Palm Beach, code for where the MDVIP FatCats are based.



Was this information meeting arranged by MDVIP or by your doctor?

Have absolutely no clue..


Only update to all this - got a callback from Palm Beach FatCat office - yes, there will be "light refreshments". Probably cheese & crackers, assorted fruit slices, maybe cookies and punch. IOW, a really cheesey, El Cheapo spread. :x

Meanwhile, in the main dining rooms next door, people will be enjoying fresh local rockfish, or Maine lobster flown in that morning, filet mignon, escargot. :(
Seems cruel and unusual to me :P :P

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Re: Concierge medicine Worth It????

Post by toofache32 » Thu Jul 12, 2018 10:34 pm

drawpoker wrote:
Thu Jul 12, 2018 10:10 pm
Miriam2 wrote:
Thu Jul 12, 2018 6:55 pm

Drawpoker, I didn't quite understand this.

Me, neither!


Do you mean your doctor, who recently went with concierge with MDVIP, has scheduled a meeting with all her patients together, presumably in a large room, to give them information on her new concierge system, and that the meeting place is a Yacht & Country Club with complimentary valet parking?

Exactly. Except not sure about the part "to give them information" as you say on new system. Cynic that I am, I think she hasn't gotten a rousing response to the initial announcement (it has been over a month now) and this so-called "informational meeting" for patients is going to turn into a slick sales pitch to sign up.



Is this in addition to - or rather than - sending the information to the patients with a letter and the name of a person in the doctor's office to contact if you have questions?

Definitely in the "addition to" category. Also, btw, from the git-go, the contact person and # for information is most definitely NOT someone in the doc's office - it is area code Palm Beach, code for where the MDVIP FatCats are based.



Was this information meeting arranged by MDVIP or by your doctor?

Have absolutely no clue..


Only update to all this - got a callback from Palm Beach FatCat office - yes, there will be "light refreshments". Probably cheese & crackers, assorted fruit slices, maybe cookies and punch. IOW, a really cheesey, El Cheapo spread. :x

Meanwhile, in the main dining rooms next door, people will be enjoying fresh local rockfish, or Maine lobster flown in that morning, filet mignon, escargot. :(
Seems cruel and unusual to me :P :P
So first you said it was too high class. Now you're saying it's too low class??

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Re: Concierge medicine Worth It????

Post by Miriam2 » Thu Jul 12, 2018 10:44 pm

drawpoker wrote:
Miriam2 wrote: Do you mean your doctor, who recently went with concierge with MDVIP, has scheduled a meeting with all her patients together, presumably in a large room, to give them information on her new concierge system, and that the meeting place is a Yacht & Country Club with complimentary valet parking?
Exactly. Except not sure about the part "to give them information" as you say on new system. Cynic that I am, I think she hasn't gotten a rousing response to the initial announcement (it has been over a month now) and this so-called "informational meeting" for patients is going to turn into a slick sales pitch to sign up.
It did sound a bit like the free-dinner sales pitches brokers use to snare eager investors :wink:
Miriam2 wrote: Is this in addition to - or rather than - sending the information to the patients with a letter and the name of a person in the doctor's office to contact if you have questions?
drawpoker wrote: Definitely in the "addition to" category. Also, btw, from the git-go, the contact person and # for information is most definitely NOT someone in the doc's office - it is area code Palm Beach, code for where the MDVIP FatCats are based.
That makes it more likely the free crackers & cheese informational meeting is a pitch from the big company MDVIP, again apparently modeled on the free dinner for eager investors. I'm a little dismayed . . .

My doctor recently retired and his office mate is now concierge at $2,000 per year. I use my general physician once or twice a year, other doctor visits are specialists (dermatologist, etc). This means I will be paying either $1,000 or $2,000 per visit to my general physician :shock: :shock: Seems like the only way this can work is if the patient is a high doctor-use patient (perhaps with a heart condition, diabetes, etc).

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Re: Concierge medicine Worth It????

Post by drawpoker » Thu Jul 12, 2018 11:37 pm

Miriam2 wrote:
Thu Jul 12, 2018 10:44 pm

My doctor recently retired and his office mate is now concierge at $2,000 per year. I use my general physician once or twice a year, other doctor visits are specialists (dermatologist, etc). This means I will be paying either $1,000 or $2,000 per visit to my general physician :shock: :shock: Seems like the only way this can work is if the patient is a high doctor-use patient (perhaps with a heart condition, diabetes, etc).
Don't know what your age group is Miriam2 (I am on Medicare) but what springs to mind - just because you now see your G.P. only once or twice a year - that could change in a heartbeat (no pun intended) So that $2,000 per year could easily be broken down divisible by four, six, eight, ten, twelve To look at it realistically, right?

But - don't think that is really the issue here. As others have posted (and wrestled with) patients who have been with the same PCP for many years, pretty much satisfied with the services, et al - well, the prospect of having to find a new doc
is daunting. Esp. if you are in a very rural area (like me) and the choices are very, very limited. Also, if you have multiple serious medical conditions (including cancer) and your PCP has guided you to the correct people (specialists) over the years, (not the duds, of which there are some out there) That also makes you pause, consider.
Or, to look at it in true BH philosophy :wink: Is it better to pay a little more. Just to keep the Devil you Know, versus the alternative. The Devil You don't Know.

Don't know just what type of concierge model your G.P. went to (?) Maybe their's is diff from the MD-Vip business model.
With MD-Vip, the docs agree to limit their practice to no more than 600 patients. The sales hook being, of course, that by restricting the practice, the doc will be able to devote more time and attention to each patient. That is the hype being given out.
Of course, it doesn't take a genius to figure out, that the doc makes up the $$ difference by raking in the annual per patient fee. Miriam2, that $2,000 per year you quoted. How is it paid? Directly to the doc, or to a 3rd party org like MDVip?
It does make a difference. At least with the MD-Vip affiliation agreement, patient pays the vendor directly, they take their cut ($500) and send the rest on to the doc.
Please share the details of how your G.P. "concierge" service is structured....???

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Re: Concierge medicine Worth It????

Post by boomer » Fri Jul 13, 2018 1:48 am

My husband's doctor is going to this business model. I think she is charging $1500 per year. He was wondering if he should do it. Decided against it though because he has had some issues that honestly she has been no help with! So I can see how, if you have a good doctor, you may feel it is worth it. We live in a smallish area and haven't really found a doctor that we think is great. I go to a Physician's Assistant that has been fine for what I have needed. My husband has been to several doctors here and they are all very nice...but it's better to have a very competent doctor even if he is a jerk. Haha. Like Dr. House I guess.

I appreciate the comment that was made about good doctors being associated with medical schools. We have a medical school about 80 miles away so perhaps we should investigate some doctors there. It would definitely be worth the drive.

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Re: Concierge medicine Worth It????

Post by eucalyptus » Fri Jul 13, 2018 10:17 am

Two points:

Teaching hospitals - my father has stage 4 pancreatic cancer and his oncologist teaches at one of the best known teaching hospitals. One issue you may find is that your doctor sees patients only one day a week, and may be very difficult to reach on other days. You may find yourself visiting emergency rooms closer to home when the need arises - so that such care is not provided by your oncologist, and you will to deal with the transfer of medical records, communication between physicians. differing assessments of condition and prognoses by different docs. It can be frustrating. When you really are exposed to how patients are treated, you may be dismayed. My observation is that hospitals are full of very kind techs and nurses, and partially informed, very busy docs you see perhaps once a day. My father is elderly and his condition hopeless, so that may be influencing the care he receives. DO NOT let anyone you care about be hospitalized without an aggressive, intelligent wingman to monitor everything.

Concierge practice. I have been a member of a couple and have loved them. Costs in the urban areas in which I’ve lived hover around $2000/year. I view it as a luxury - easy access for treatment of minor maladies and monitoring of over all health. For anything significant, you will be referred out. The docs have spent a lot of time with me discussing all aspects of my health, something a traditional doc may not have time to do. Overall, I’d emphasize that it’s a luxury, plain and simple.

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Re: Concierge medicine Worth It????

Post by dm200 » Fri Jul 13, 2018 10:24 am

It seems to me that one financial benefit for Physicians doing this is that there is little paperwork or expense in the annual fee. No insurance forms to file, no waiting for reimbursement, no rejections, etc.

As I posted before, with our Kaiser plan, we seem to get many of the benefits of this type of practice - but without the added costs.

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Re: Concierge medicine Worth It????

Post by dm200 » Fri Jul 13, 2018 10:26 am

boomer wrote:
Fri Jul 13, 2018 1:48 am
My husband's doctor is going to this business model. I think she is charging $1500 per year. He was wondering if he should do it. Decided against it though because he has had some issues that honestly she has been no help with! So I can see how, if you have a good doctor, you may feel it is worth it. We live in a smallish area and haven't really found a doctor that we think is great. I go to a Physician's Assistant that has been fine for what I have needed. My husband has been to several doctors here and they are all very nice...but it's better to have a very competent doctor even if he is a jerk. Haha. Like Dr. House I guess.
I appreciate the comment that was made about good doctors being associated with medical schools. We have a medical school about 80 miles away so perhaps we should investigate some doctors there. It would definitely be worth the drive.
Yes - I especially use that "standard" for surgeons!

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Re: Concierge medicine Worth It????

Post by robebibb » Fri Jul 13, 2018 11:31 am

eucalyptus wrote:
Fri Jul 13, 2018 10:17 am
Two points:

Teaching hospitals - my father has stage 4 pancreatic cancer and his oncologist teaches at one of the best known teaching hospitals. One issue you may find is that your doctor sees patients only one day a week, and may be very difficult to reach on other days. You may find yourself visiting emergency rooms closer to home when the need arises - so that such care is not provided by your oncologist, and you will to deal with the transfer of medical records, communication between physicians. differing assessments of condition and prognoses by different docs. It can be frustrating. When you really are exposed to how patients are treated, you may be dismayed. My observation is that hospitals are full of very kind techs and nurses, and partially informed, very busy docs you see perhaps once a day. My father is elderly and his condition hopeless, so that may be influencing the care he receives. DO NOT let anyone you care about be hospitalized without an aggressive, intelligent wingman to monitor everything.
Your father should be able to see other providers at the oncology practice even when his Dr. is not in the office. This would be more effective than visiting the ER when an issue arises. If an ER visit is needed it may be best to visit the ER affiliated with the oncology group your father is using so they can be in the loop.

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Re: Concierge medicine Worth It????

Post by toofache32 » Fri Jul 13, 2018 11:41 am

robebibb wrote:
Fri Jul 13, 2018 11:31 am
eucalyptus wrote:
Fri Jul 13, 2018 10:17 am
Two points:

Teaching hospitals - my father has stage 4 pancreatic cancer and his oncologist teaches at one of the best known teaching hospitals. One issue you may find is that your doctor sees patients only one day a week, and may be very difficult to reach on other days. You may find yourself visiting emergency rooms closer to home when the need arises - so that such care is not provided by your oncologist, and you will to deal with the transfer of medical records, communication between physicians. differing assessments of condition and prognoses by different docs. It can be frustrating. When you really are exposed to how patients are treated, you may be dismayed. My observation is that hospitals are full of very kind techs and nurses, and partially informed, very busy docs you see perhaps once a day. My father is elderly and his condition hopeless, so that may be influencing the care he receives. DO NOT let anyone you care about be hospitalized without an aggressive, intelligent wingman to monitor everything.
Your father should be able to see other providers at the oncology practice even when his Dr. is not in the office. This would be more effective than visiting the ER when an issue arises.
Yes most group practices will have their partners or their Noctors available for existing patients.

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Re: Concierge medicine Worth It????

Post by dm200 » Fri Jul 13, 2018 11:50 am

Yes most group practices will have their partners or their doctors available for existing patients.
That has been my experience with group practices as well.

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Re: Concierge medicine Worth It????

Post by eucalyptus » Fri Jul 13, 2018 1:04 pm

dm200 wrote:
Fri Jul 13, 2018 11:50 am
Yes most group practices will have their partners or their doctors available for existing patients.
That has been my experience with group practices as well.
I should have been clearer. My father's ER visits have been genuine emergencies, eg severe reaction to chemo. He was transported by ambulance to the closest hospital, not to the more distant teaching hospital.

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Re: Concierge medicine Worth It????

Post by drawpoker » Fri Jul 13, 2018 1:38 pm

dm200 wrote:
Fri Jul 13, 2018 10:24 am
It seems to me that one financial benefit for Physicians doing this is that there is little paperwork or expense in the annual fee. No insurance forms to file, no waiting for reimbursement, no rejections, etc.
No, you misunderstand. These physicians that are collecting concierge fees in the $1,650 - $2,300 range are still filing insurance on their patients. The annual concierge fee does not take the place of the usual charges for office visits and other things.

What you are thinking of - the purest form of concierge medicine which sprang up years ago on Park Avenue, Beverly Hills. Those doctors did forego filing insurance, but the annual fees for this type concierge service were in the $10,000 to $20,000 range. So that part made sense, financially speaking.

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Re: Concierge medicine Worth It????

Post by dm200 » Fri Jul 13, 2018 1:43 pm

drawpoker wrote:
Fri Jul 13, 2018 1:38 pm
dm200 wrote:
Fri Jul 13, 2018 10:24 am
It seems to me that one financial benefit for Physicians doing this is that there is little paperwork or expense in the annual fee. No insurance forms to file, no waiting for reimbursement, no rejections, etc.
No, you misunderstand. These physicians that are collecting concierge fees in the $1,650 - $2,300 range are still filing insurance on their patients. The annual concierge fee does not take the place of the usual charges for office visits and other things.
What you are thinking of - the purest form of concierge medicine which sprang up years ago on Park Avenue, Beverly Hills. Those doctors did forego filing insurance, but the annual fees for this type concierge service were in the $10,000 to $20,000 range. So that part made sense, financially speaking.
I understand fully. Yes - these physicians file claims for actual services provided - and have that overhead, etc. What I mean is that the annual "concierge fee" itself has little or no such overhead, delays, etc.

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Re: Concierge medicine Worth It????

Post by drawpoker » Fri Jul 13, 2018 2:09 pm

dm200 wrote:
Fri Jul 13, 2018 1:43 pm

I understand fully. Yes - these physicians file claims for actual services provided - and have that overhead, etc. What I mean is that the annual "concierge fee" has little or no such overhead, delays, etc.
Well, if that is what you meant, it still doesn't make sense to me. The concierge fee represents such a tiny portion. Say a doc grosses $300,000 a year in revenues. The MD-Vip net to the doc per year per patient is $1,150 ( starts with $1,650 less the $500 cut to MD-Vip)

That works out to less than one-half of 1 per cent. If the doc is grossing $500,000 a year, it really becomes infinitesimally small.
The absence of "overhead, delays, etc" does not strike me as such a great benefit to the physician. When it results in so much ill will, pissed-off patients leaving the practice, bad-mouthing the doc.
In my own informal survey here - patients I have talked to so far - I have been unable to find a single one who is going to pay the extra $$$ and stick with the doc.

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Re: Concierge medicine Worth It????

Post by dm200 » Fri Jul 13, 2018 2:13 pm

In my own informal survey here - patients I have talked to so far - I have been unable to find a single one who is going to pay the extra $$$ and stick with the doc.
Interesting. No direct experience either with folks who have paid this annual fee either.

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Re: Concierge medicine Worth It????

Post by dm200 » Fri Jul 13, 2018 2:16 pm

Related question/issue: When evaluating a Primary Care Physician, not doing concierge practice, what is a fair and reasonable way to determine if the Physician has adequate capacity for patients or is "over booked"?

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Re: Concierge medicine Worth It????

Post by dm200 » Fri Jul 13, 2018 2:36 pm

dm200 wrote:
Fri Jul 13, 2018 2:16 pm
Related question/issue: When evaluating a Primary Care Physician, not doing concierge practice, what is a fair and reasonable way to determine if the Physician has adequate capacity for patients or is "over booked"?
Maybe put another way - how common or uncommon is it for a Phyician or a group practice to decline to take on new patients because of the current patient load?

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Re: Concierge medicine Worth It????

Post by drawpoker » Fri Jul 13, 2018 2:37 pm

dm200 wrote:
Fri Jul 13, 2018 2:16 pm
Related question/issue: When evaluating a Primary Care Physician, not doing concierge practice, what is a fair and reasonable way to determine if the Physician has adequate capacity for patients or is "over booked"?
Good question! Guess you could sneak into the waiting room, take a seat in the corner, avoid the eye of the front desk person, and just eyeball the comings and goings for a while. . On diff. days, diff times of the day, of course. That is the only way I can think of to get a realistic view.

Here's another related issue: When a physician office says it is not taking any new patients (the "panels are closed" in doctor Latin- Lingo) does that mean that doctor is one of the better ones, everyone has flocked to him/her :?: (This is the case here, my PCP/geriatrist/ doc has had a closed practice for quite a while.)

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dm200
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Re: Concierge medicine Worth It????

Post by dm200 » Fri Jul 13, 2018 2:49 pm

drawpoker wrote:
Fri Jul 13, 2018 2:37 pm
dm200 wrote:
Fri Jul 13, 2018 2:16 pm
Related question/issue: When evaluating a Primary Care Physician, not doing concierge practice, what is a fair and reasonable way to determine if the Physician has adequate capacity for patients or is "over booked"?
Good question! Guess you could sneak into the waiting room, take a seat in the corner, avoid the eye of the front desk person, and just eyeball the comings and goings for a while. . On diff. days, diff times of the day, of course. That is the only way I can think of to get a realistic view.
Here's another related issue: When a physician office says it is not taking any new patients (the "panels are closed" in doctor Latin- Lingo) does that mean that doctor is one of the better ones, everyone has flocked to him/her :?: (This is the case here, my PCP/geriatrist/ doc has had a closed practice for quite a while.)
Could mean a lot of things - good or bad. Similar experience with my Kaiser plan (this time 7 years). Except in the last year, my PCP has always been available as a choice. Some are rarely available. I presume my PCP is not "popular" - although I have been very, very happy. Onlne, when I search for her, I find several terrible patient reviews and her "average" is not high.

I place close to zero reliability on how popular a doctor is vs. how good/competent. In my opinion and experience, many very popular doctors with patients are not that good. I conclude that, to d degree, doctor who tell patients what they eant to hear are very popular - and get good patient reviews.

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Re: Concierge medicine Worth It????

Post by drawpoker » Fri Jul 13, 2018 3:09 pm

dm200 wrote:
Fri Jul 13, 2018 2:49 pm

Could mean a lot of things - good or bad. Similar experience with my Kaiser plan (this time 7 years). Except in the last year, my PCP has always been available as a choice. Some are rarely available.....
The comparisons with a MA plan (like Kaiser) are not going to be the same. The docs are actually employees of Kaiser, correct? Not the same as having their own practice, calling the shots. The employer may shuffle them around, shifting some duties, etc. to suit their own needs.
In addition, probably not all the PCPs on the Kaiser list are equal in the sense of availability. Some may be full-time, others part-time. Each doc probably makes their own contractual arrangement with Kaiser.

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