Why I Switched to Concierge Medicine in 2003

I have been practicing in my independent concierge style practice since 2003. When I decided to switch from a traditional practice to a concierge membership practice, I was examining 25 to 35 patients per day in the office plus about five patients spread between three local hospitals.

At that time, managed care , with the blessing of the Center for Medicare Services (CMS), and private insurers, was flourishing . Patients of mine were now being directed by their employers and insurers to switch to doctors who had contracted with them and agreed to see these same patients for seventy-five cents on the dollar. Lab work performed in my in office “certified” lab was being directed away to national chains like Quest and LabCorp.

To make up the difference in lost income, I was advised to be more efficient and see more patients per day. So, on some days I managed to see 45 patients.

I gave it my sincerest effort in the beginning.  However, it quickly became clear that patients like Mrs. Smith, who joined the practice at age 45 and suffered from an occasional ache and pain from doubles tennis, was now 20 years older. She went from taking an oral contraceptive for perimenopausal hot flashes and irregular menstrual bleeding to being on a low dose of three blood pressure medicines, one cholesterol lowering medicine, two eye drops for glaucoma, one weekly pill for osteopenia and an anxiety / depression pill prescribed by a psychiatrist to help her deal with becoming an empty nester. She went from having two physicians, her internist and gynecologist, to having five or six. Coordinating her care in 5 to 10-minute office visits, advised by the administrative experts promoting managed care, as less expensive meant you never comprehensively covered anything. Thus, it quickly become blatantly obvious to me that taking care of fewer patients very well, by investing as much time as needed to do so, was far superior to taking care of 3,000 patients in a rushed, piecemeal fashion.

Concierge medicine in my practice offers you time and availability. New patient visits are allotted 90-120 minutes to allow the patient and me to get to know each other well. Return or follow-up appointments are generally 45 minutes long. Availability to see your physician, plus time spent being proactive with your care rather than reactive, is proven to improve health outcomes and reduce ER visits and hospitalizations.

During regular office hours, my staff answers the phone not an automated attendant. For after office hour emergencies you have the option of calling my cell phone directly.

Patients phone calls are returned the same day. Requests for prescription refills are completed before the office is closed at the end of each business day. If a health concern requires same day attention, I will see you in the office or send you to the emergency room, depending on the type and severity of the concern. 

By having more time to spend than I did in a regular practice, I am able to advocate for my patients.  I doggedly do so whenever the situation requires it.

When your medical condition warrants you be seen quickly by a specialty physician, we call their office and make the arrangements. We are fastidious in making sure what we call an emergency is actually a medical emergency so when we call and ask for a quick appointment, they appreciate the fact that we respect their time as well as our patient’s.

When prospective patients arrange a complimentary “meet and greet “ session with me. we stress availability, time and advocacy. My staff is customer service trained, oriented and compassionate.  My practice is set in a convenient location with a relaxing atmosphere.

There are fewer and fewer primary care doctors coming out of medical school and residency programs. Most of those that do are faced with six-figure student loan debt and lifestyle pressures which makes an  employed position with a for-profit look appealing. However, their contracts have volume and revenue generating parameters which, if not met, result in termination or less compensation offered the next contract period.

A few enlightened ones find concierge medicine or direct pay membership practices and remain independent so that their relationship with the patient has no insurer drug benefit manager or pre procedure authorization company standing in the way of the health care you and your doctor decide you need!

I began providing concierge-level care in 2003 because at the end of every day you have to be able to look yourself in the mirror and say that you did the best job you possibly could!  Making the decision to change to concierge medicine was the right decision for my patients, and myself, and I’m glad I made it when I did!

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