My year with a concierge doctor

In 2017, I spent $1,400 for a subscription to a concierge doctor, one who charges extra to offer better access for her patients and has far fewer patients than the typical hospital system doctor. Other terms for this type of practice are concierge medicine, boutique medicine, private medicine, retainer medicine, and maybe subscription medicine. The doctor I ended up choosing had 350 patients, which she said is 1/10th of the usual caseload. Doctors in larger and more affluent metro areas might have more patients. Your health insurance is used wherever applicable, but not for the annual fee, obviously. 

Long story short, if you can afford it and are not particularly attached to your current doctor, I would recommend a concierge doctor. I found that having one reduced my anxiety about access to decent medical care during potentially serious health issues or hospitalization. I am not convinced that having one would lead to a faster resolution of a chronic, undiagnosed illness.

I had wanted to try the concept out ever since a good friend had described her private doctor as if she actually  gave a shit about her. This was shortly after private doctors first appeared in the mainstream media. The concept was met with indignation by some who felt it contributed to a class-based standard of care. At the time, I couldn’t find one in my backwater area and couldn’t have afforded it anyway.

My reasoning for looking for one: I had moved to another part of the country and wanted to find a doctor who actually remembered me from visit to visit. Also, even though I rarely use my health insurance, because it does not cover much complementary care, I would like to not have to wait weeks for appointments when I do go mainstream.

Choosing the doctor was easy. There were only two women on the rolls of the two concierge services listed in town, and I chose the one in the neighborhood with the least smog and most convenient parking.

What the doctor gets out of concierge medicine

  • Much of the administrative infrastructure for the office, including the patient web portal, is handled by the umbrella concierge company. 
  • The doctor can afford to have far fewer patients and, presumably, work hours.
  • The doctor can spend more time with each patient.

Advantages for patients

  • What decided it for me: the doctor is much more likely to keep good tabs on you if you are hospitalized. I had heard several nightmare stories from family members on this topic over the years.
  • Faster response from the doctor and the office
  • Shorter wait times for appointments
  • Closer relationship with doctor and staff
  • Close monitoring of a set of health markers administered twice a year as part of the fee.  I felt like they created a more realistic picture of my health than the usual PPO programs did. (However, I am not an expert on what the norm is.)
  • For those of you with chronic, undiagnosed illnesses, I am guessing that a concierge doctor would be more willing to order all those wacky diagnostic tests you find during your endless research. I rarely bothered my  PPO doctor with these requests because I am tired of the constant pushback. Usually I would just go to a complementary medicine doctor. (As I mention in this post, I have almost never actually been refused by a PPO doctor for these requests. I just can only take so much of the effin’ attitude.) HOWEVER, I did not find that my concierge doctor had a wider scope of vision regarding chronic, unexplained illnesses than any other mainstream doctor I have been to. 

My experience: the good

The doctor was an interesting person with an office that felt quite homey. She had been in the community a long time, knew a lot of specialists and had many community ties. She had a very large community vegetable garden out front that patients volunteered to work in, and had two parties a year with a band and barbecue. She also hosted about seven speakers a year on topics such as the a state-funded healthcare proposition, caring for the elderly, preparing financially for an Alzheimers diagnosis, etc. I went to two and found them worth my time. 

Because I was so used to inept American healthcare standards, it didn’t occur to me to call my new doctor’s office for help until after I’d spent seven miserable days with a wracking cough. I left a voicemail on a Sunday night and the doctor herself called me back 20 minutes later, spent 20 minutes on the phone with me — during which she chastised me for waiting so long: “WHAT AM I HERE FOR?” — and then called the pharmacy with the prescriptions and gave me detailed instructions for each.

My experience: the bad

  • Communication between the staff members was not always perfect.
  • It took me three phone calls just to arrange an intro meeting with the doctor once I found her on the company’s website. Same thing happened when I moved to another state and started a new search.
  • The advertised benefit of shorter office wait times did not come to pass. I waited an average of 45 minutes before every appointment.
  • The doctor seemed as rushed as any other I’d met, although she always spent far more time with me than any other doctor I’ve had — except for Needleman, Acupuncturist Extraordinaire — and made sure all my questions were answered. 
  • The web portal is confusing. I never did successfully sign on on the first try.
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When I had to drop the service for budgetary reasons, I missed it enough that I considered taking advantage of the much lower costs of a health share plan and splitting the difference to pay for the concierge service. However, my application at the one program I applied to was accepted with so many conditions that I was afraid it would be used to deny coverage on almost anything I sought care for, except maybe a catastrophic incident. The cost of the health share program had also increased significantly twice in 18 months, which I felt did not bode well for the future, so I abandoned the idea. 

 

 

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