Imagine your ideal patient/physician experience! You call your primary care doctor Monday morning and arrange an appointment for that same afternoon. She arrives on time, having already reviewed your medical records, and spends enough time with you to do a thorough exam and address all your concerns. If necessary, she actively helps you manage your chronic conditions, guiding you through your treatment options, coordinating your care with appropriate specialists and following up with you regularly.
This is the promise of concierge or boutique medicine, a trend gathering momentum in primary care in affluent communities. Patients in a boutique practice pay an annual fee of $1800 to $2500 or more for attentive care. Most concierge practices offer longer appointments, same-day appointments, comprehensive preventive care, management of chronic conditions, and direct physician access through cell phone and email.
In today’s world of increasing costs and stagnating insurance reimbursement, primary care physicians in standard medical practices must see more and more patients to maintain their income. With 2100 patients in their practices, many doctors see 20-30 people per day. Practice management expert, Debra Phairas, of Practice and Liability Consultants, calls this the “hamster wheel model”.
This new boutique practice model is a win for doctors; they spend more time on direct patient care, have no insurance and billing issues, and earn 50% to100% more. A concierge practice often consists of as few as 300 patients. A Medical Group Management Association survey shows that the average primary care physician earns $207,000 a year while boutique practitioners earn between $307,000 and $462,000.
Phairas predicts that “the number of primary care, pediatric, and internal medicine practices transitioning to a concierge model will increase significantly in the coming years.”
But the very economics that makes the concierge model appealing to doctors, makes it unaffordable to most patients. This trend adds to the increasing scarcity of primary care doctors at a time when health reform promises to provide insurance to 32 million new people.
A number of our clients are signing up for these boutique practices; others have had to scramble to find a new medical home. Don’t be blindsided; we urge you to initiate the conversation with your doctor. Find out what’s ahead so that you can plan appropriately for your medical care.
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