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Are concierge doctors worth the price?

Some people are VIPs -- very important patients, --who get more attention from their doctor with less waiting. As you might imagine, there's a price to pay.

By Stacy Johnson Dec 19, 2011 10:46AM

This post comes from Brandon Ballenger at partner site Money Talks News.

Money Talks News on MSN MoneyAn apple a day may help keep the doctor away, but if you have to see them right now? You may need a lot of something that doesn't grow on trees.

Instead of waiting days or weeks for a brief appointment with a physician, you can use what's called concierge medicine, direct care or, perhaps most descriptively, retainer medicine. On top of the usual costs, patients pay an annual retainer fee -- ranging from hundreds to thousands, depending on the practice -- to join a small group of patients who get special treatment, including same-day appointments and sometimes 24/7 access to the doctor.

In the video below, Stacy Johnson examines what this service offers, and at what cost. Check it out, then read on for more.

In a typical practice, a family physician might have 1,000 patients or more. In a concierge practice, 400 is more typical. For patients, that translates into longer appointments, less waiting, and more personal attention. For doctors, it means a more satisfying and less stressful workday.

As Stacy mentioned, while it's been around for more than a decade, this kind of practice is only just starting to take off. A government report (.pdf file) found 146 retainer physicians in 2005, and 756 last year. Last month, the American Academy of Private Physicians gave higher numbers, estimating "about 3,500 concierge doctors nationwide … (and) the number should double every 12 to 18 months for the next three years."

The irony of retainer medicine is that what now constitutes concierge care used to be the standard, at least in terms of how many patients a doctor sees during an average day.

Concierge doctor Steven Reznick explains that when he began practicing in 1979, he'd see 10 to 12 patients per day, the same number he now sees in his concierge practice. But over the years, a decrease in revenue per patient meant he was forced to see more patients daily to maintain his standard of living. When he left his traditional practice, he was seeing 25 to 30 patients per day -- typical, he says, of today's family physician.

In short, the concierge physician charges an annual retainer simply to spend as much time with each patient as doctors did 30 years ago.


Is concierge care for you? You have to ask a lot of questions. Here are a few things to consider:
  • Distance. Is there a concierge practice near you? While the report  mentioned above says concierge service is available in all but 11 states, it's heavily concentrated in urban areas like Los Angeles, Miami, and Washington, D.C. You can look up concierge physicians in your area at the American Academy of Private Physicians website.
  • Services. There's no standard definition of what constitutes concierge service, so ask a lot of questions. Are there same-day appointments? Is there 24/7 access to the doctor (or an assistant?) How much time am I guaranteed with the doctor? Does the doctor do house calls, more extensive tests, or email consultations? What kind of preventive care (such as screening exams or wellness plans) is included? What else is included? In short, find out what you're paying extra for.
  • Price. Like the service, the fee isn't standardized. The physician Stacy talked to charges $1,800 a year for individuals and $3,600 for families, which is about the average. The MedPAC report says that "a typical retainer fee appears to be about $1,500 to $2,000, although the physicians we interviewed charge from $600 to $5,400." Most, but not all, concierge doctors take insurance. You may also be able to pay in part through a work-based plan like an FSA or health savings account.
  • Need. After knowing the perks and the price tag, the big question: Is it worth it? As Stacy mentioned, those with chronic conditions such as diabetes may appreciate more frequent and thorough care, as may older patients and those with multiple illnesses. Longer visits could also save both money and your health through early diagnosis. And for some impatient patients, the time saved alone -- from being out sick or in the waiting room -- may be worth the annual fee. If, that is, you can afford it.

More on Money Talks News and MSN Money:

Dec 19, 2011 6:42PM

I live in the rural midwest. All of our community docs take Medicare and Medicaid, and if you don't have insurance, they will see you anyway and send a bill. No wallet biopsy. The only problem is that, if you aren't having an emergency, it takes six weeks minimum to be seen. Of course, we still have 24/7 access to the physicians, because their home phone numbers are in the telephone book.

I was sitting in my doc's office this morning, reading (of all things!) a physician management magazine. One article recited that 51% of hospital and clinic administrators do not want to repeal the Patient Accountability and Affordability Act. The devil you know must be better than the devil you don't. It also recited that hospital clinic administrators anticipate decreased patient access under the act because they will have to reduce staff. Also, because more people will presumably be able to get insurance, they predicted increase waiting periods to get an appointment.

My mother lived in a retiree magnate state. She complained constantly that she couldn't find a physician who took Medicare, worked more than three days a week, or was available by telephone for anything. I think we may all be coming to that. Suddenly concierge care looks more attractive. Of course, no Medicare for concierge practices, so it is really a matter of did you read and follow all those other Smart Spending articles on saving for retirement?

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