pros and concs of concierge medicine

Pros and Cons of Concierge Medicine for Patients

Are you wondering if concierge medicine could improve your personal quality of medical care? If you have experienced long wait times to see a doctor or feel that your physician has too little time for you, concierge medicine might be an option for you. But because we don`t believe in one seize fits all we would like to discuss the pros and cons of concierge medicine to help you make the best healthcare choices for yourself.

What is Concierge Medicine?

Most Concierge medicine services give you same day doctor’s appointments and access to 24/7 on-call physicians. These services are covered through a membership model which is usually not covered by insurance. Their pricing differentiates on the level of services and age as you will see in our examples. below.

Concierge Medicine in Florida

Before discussing the pros and cons of concierge medicine for patients we looked at what concierge medicine in Florida looks like. In addition, we had an even closer look at concierge medicine in Lee County (SWFL).

There seem to be two big companies offering concierge services on state level. There are the University of Miami and the Cleveland clinic. 

University of Miami Concierge Medicine

UHealth provides the best innovative care in an academic medicine setting. Their goal is to help patients prevent disease through the following services:

  • “Little to no wait times with unhurried office visits
  • Same-day or next-day appointments with your Premier Physician
  • Convenient, on-site laboratory and imaging facilities
  • Complementary adjacent parking when visiting your Premier Physician’s office
  • Comfortable environment serving beverages and snacks”

Cleveland Clinic Concierge Medicine Program

Patients in Cleveland Clinic Florida’s Concierge Medicine Program have immediate and continuous access to their personal Concierge Medicine Program physician and healthcare team, 24 hours a day, seven days a week. The clinic provides each patient with a highly-personalized health assessment and ongoing health management program. Their emphasis is on prevention. This means 

  • “an annual, in-office comprehensive physical exam and medical history, on-site blood draw, an electrocardiogram
  • a customized wellness plan for your personal health goals
  • direct communication with your physician through telephone or email 24/7
  • coordination of care with specialists and hospitalists
  • coordination of care with specialists and hospitalists
  • access to your healthcare records through MyChart
  • support and coordination of care or medical emergencies even when traveling for business or vacation”
  • physicians will coordinate care with specialists in both Florida and Ohio.
  • Membership fee is not covered by an insurance

Both offers include services of high qualified clinics compared to services of local clinics as we will see in our Lee county example. 

Concierge Medicine Lee County Florida 

Lee county has a population of approximately 770.000 people and is situated in Southwest Florida. We were unable to find more than 5 concierge medicine physicians. 

Example 1: Private Physicians of Florida

“Simply stated, concierge medicine (also known as private medicine, direct medicine or boutique healthcare) is a model of care defined by a direct financial relationship between doctor and patient, in which the doctor accepts payment only from patients, and not from insurance companies, hospitals or government agencies. This is the only model that can ensure your doctor works only for you, with no conflicts of interest.”

We think that this sounds like a very healthy and common sense relationship. In addition, it is also convenient and presents the doctor as a patient`s advocate.

Example 2: Tritel Concierge Medicine 

“The concept of concierge medicine is reducing a doctor’s the number of patients by 80-90 percent to allow more time to spend with each patient and to provide more personalized care. At TCM, Dr. Tritel will limit his practice to 300 patients to ensure that you will receive the highest quality of care. Instead of seeing 20 to 25 patients in a day, Dr. Tritel sees three-to-five patients, which allows him to spend the necessary amount of time with each patient. Furthermore, this allows Dr. Tritel to offer same day or next day appointments and longer appointments with minimal wait time. He will visit you in the hospital, assisted living facility, nursing home, or residence when indicated. Dr Tritel will always be reachable 24 hours a day, including by cell phone after office hours and on weekends. “

This model seems to be highly personal as the doctor visits the patient wherever needed – even in nursing homes. Both examples are financed through a membership model. After understanding how concierge medicine works, we present the pros and cons of concierge care.

Example 3: Internal Medicine of Southwest Florida – a Hybrid Model

Internal Medicine of Southwest Florida offers a so-called private hybrid concierge model. Their argument is that During the cost of operating a medical practice has increased by 35%. Whereas reimbursement has declined over the last 18 years. 

As a result the physicians offer private contracting plans and in addition so called itemized Fees: “include preauthorization of tests and medications, insurance company requests for information or if you desire copies of your medical record for your personal use.

  • $20 for simple paperwork.
  • $35 for complex paperwork which includes a chart review and requires greater that 30 minutes of staff time.
  • $35 for phone calls to insurance companies and pharmacy benefit plans with an added charge of for long calls.
  • $20 for phone calls requesting medical information or treatment.
  • $50 for time intensive calls requiring 30 minutes or more of staff time.
  • $1.00 per page for the first 25 pages then .25 for each additional page of medical records for personal use”

Example 4: Inpatient Advocate Service – Concierge Service For Hospital Support

When you are hospitalized your primary care doctor personally ensures that you get the best hospital care possible. To do that he will visit you and communicate with the clinic`s doctor`s and nurses to improve your quality of care and give you comfort.

Pros and Cons of Concierge Medicine in Florida

There are definitely interesting concierge medicine options in Florida – on state and county level. But they are all very expensive and you need to check their individual quality in a trial. to see if they serve your personal need.

The “Pros” of Concierge Care

Faster Access To Medical Care

Many concierge practices offer 24/7 day and night medical care. Instead of talking to voicemails and waiting for days for a reply patients can even text their doctors on Sunday night. Therefore, they can have conversations about their health and thus make better health choices for themselves.

Better Communication

Because you are a member, the doctor’s office can handle your needs on a personal level. No matter if you need a screen or appointment with another specialist. 

In-house Specialization

Concierge practices are normally very well equipped. Therefore they can save you time by treating matters in-house, when possible, rather than making you drive to a specialist. When choosing a concierge doctor ask which treatments they can offer in-house. Choosing a bigger company on state level can also give you fast access to specialists as seen in case of the Cleveland Clinic concierge medicine offer.

Care Coordination

Some concierge practices assist you in scheduling any specialist appointments that you might need to set. Others as we learnt above even visit you at the hospital to check your medical situation and can assist you in making better health choices by navigating you through today’s complex medical system.

Your doctor as your advocate

Because you pay your concierge medicine provider in person he or she is incentivized to look at your interests first. Instead of being paid by your insurance company and thus having to keep on eye on their interests as well. 

Of course, there are “pros” that vary from one physician to the next. But you get the idea — concierge medicine gives you easy access and personalization that traditional practices cannot achieve in most cases. 

The Cons of Concierge Medicine

We read a story about a doctor who decided to leave life as a concierge doctor behind after many years. Here are some of his reasons.

Quality of Care

The doctor pointed out that as a concierge doctor they  didn’t measure the quality of the care. They didn`t collect any data on outcomes. Whereas in his new job working in a bigger clinic they have dashboards with quality outcomes and accountable metrics. This is very important because when spending money out of your pocket you want at least better care in return.

Limited Services Possible

Depending if you sign up with a local doctor or a university hospital like our example of the university of Miami you get different services. Bigger clinics can usually offer: integrated behavioral health, care management, palliative care, nutrition, and clinical pharmacy on-site in the clinic.

Membership Fees

Concierge doctors offset costs by charging a membership fee. Those fees are not payable by your insurance or by your FSA or HSA. As a result your membership is an extra out-of-pocket expense. The joining fee can range from less than $100 to well into the thousands. It seems relatively affordable at a younger age but gets pretty expensive once you get over 65. We found offers that charge you with up to nearly $5.000 annually.

Limited Insurance Cooperation

Concierge medicine does not replace the need for medical insurance. You will still need insurance to cover other healthcare costs such as blood work, diagnostic imaging (X-rays, MRI, etc.), specialists visits, allied healthcare (physical therapy, occupational therapy, etc.), emergency room and urgent care visits, and hospitalizations. You may elect to choose a high-deductible insurance to offset some of these expenses. In addition, most concierge practices do accept insurance from many insurance carriers — not for membership but for treatment. That said, there are physicians that accept fewer carriers than a traditional practice might. For example, many concierge offices aren’t working with Medicare or Tricare.

Healthy People Don`t Go To the Doctor often 

A concierge membership makes the most sense for people who want or have to to see their doctors regularly. If you’re healthy anyway and don`t make regular checkups a priority, this model might be a waste of money. This is most likely the case for people below 65.

Lack of Proximity to Concierge Doctors

Also concierge medicine has been  popular for years, nearby options might be limited. Taking the Lee County example, we couldn’t find more than five concierge options. Still it seems that those doctors were not maxed out for their client slots and still ready to accept new patients.

It is a Business after all

The doctor that left concierge medicine after many years was tired of having too much economic responsibility. This reminds us that concierge medicine is a business after all. Therefore, your medical advocate has also a certain economic pressure. 

Is Concierge Medicine Right For You?

If you are aiming for a healthier and longer life, receiving better healthcare is only one part of your journey. At Simplesavvysmart.com we believe that there are three steps. High levels of health literacy, more Self-care and better medical care.

High Levels of Health Literacy

Let`s look at some statistics.

The general adult skills surveys (Australia, Canada, United States) show between 36% and 60% of the adult population may have low Health Literacy levels.” (Source: read.oecd-ilibrary.org) 

Why this matters: Low Healthy Literacy reduces our ability to make the right healthcare choices for us.

Here is another statistic on health literacy that points out why healthy literacy is so important. “The odds of having an infectious complication within a month after an operation were 4.5 times higher in patients with low health literacy compared with patients whose health literacy was adequate. (Source: facs.org)

Why this matters: Health literacy is the single best predictor of an individual’s health status. (Source: www.ncbi.nlm.nih.gov) Therefore we need it to lead a healthier and better life. 

But What is the best way to improve our health literacy?

The single strongest effect on health literacy rates, regardless of education level, are achieved through daily 

  • reading of books, 
  • newspapers, 
  • magazines,
  • websites, (Source: read.oecd-ilibrary.org/Canadian Council on Learning, 2008)

More Self-care

A healthier and better life mainly depends on leading a healthy lifestyle. This includes holistic fitness and our ability to take good care of ourselves. For more details read our articles on Holistic Fitness, self-care statistics and self-care Sunday ideas.

Effective Medical Care

Unfortunately there is no simple answer to what effective and therefore better medicine is. But one thing is for sure. Effective medical serves your personal needs – no matter which genes or medical condition you are in. First of all, it starts with being a good self-advocate. Therefore looking at the pros and cons of concierge medicine is a valuable lesson that helps you on your journey not navigate through a healthcare system that has its limitations. The fact that you are reading this article and others like it is a great sign that you’re a good health advocate already. There are certainly alternatives to concierge medicine.

A Word from Simplesavvysmart.com 

Your relationship to your current primary physician might already be very positive. In this case concierge medicine might only be an option for hospital care or on state level to access to university quality care. 

Have the courage to make good healthcare decisions – you will love what you can be.

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