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What Is Concierge Medicine And Is It Worth The Price Tag?

By June 5, 2022July 20th, 2022Concierge Doctor

The last time you scheduled a same-day appointment with your doctor was probably a while ago. There’s usually a wait or a hassle over a copay or deductible when you go to the doctor. But if you went in and discussed the stress of your new job and alternatives to anxiety medication, it would be a different story.

What Is Concierge Medicine?

Concierge medicine is a type of healthcare that is becoming increasingly popular, especially among those who want more personalized and convenient care. This type of care usually involves a membership fee that gives patients more direct access to their doctor.

You can get unlimited office and telehealth visits each month for a flat fee, so you can see your doctor as often as you need without worrying about copays or other charges. You’ll also have access to your doctor’s direct phone line for medical questions, simple diagnostics, and blood tests. Your doctor will coordinate specialist referrals and hospital care if you have a significant health problem. Concierge medicine is a type of healthcare in which doctors and patients work together without insurance or corporate health system interference.

The concierge model appeals to primary care physicians and their patients, says Dr. Eric I. Ray, a family medicine physician at Southlake Pain Relief, Southlake, TX. Administrative burdens in the healthcare industry can lead to burnout and unhappiness among employees. The idea of primary care on demand is attractive because it would allow employees to return to doing what they love.

Concierge Medicine vs. Traditional Primary Care

The average wait time to see a traditional primary care physician in a large metropolitan area is 24 days. This is because traditional primary care physicians can have a patient panel of up to 4,000 people and see up to 40 patients daily for no more than 15 minutes at a time.

“In a busy insurance-based primary care practice, you may not have enough time with patients,” says Dr. Eric I. Ray., founder and medical director of Southlake Pain Relief, a direct primary care practice in Southlake, TX. “Doctors may be paid for how many people turn the turnstile.” Patients who opt for traditional primary care are often dissatisfied with the lack of availability to their physician. “They appreciate their doctor but are unhappy with the office,” he says.

The traditional primary care physician routine is familiar to many people. After waiting for an appointment for weeks, you finally see the doctor and have some basic tests and screenings done. However, you then have to wait days or weeks for the results to be uploaded to an online portal, which can be frustrating. If you are fortunate, you will have the opportunity to discuss your results with a nurse over the phone.

The concierge model of medicine is much more focused on the patient experience. Physicians who participate in concierge or direct primary care typically have a smaller patient panel, often no more than 600 people. This allows them to know their patients better and provide more personalized care.

The doctors see an average of six to 10 patients daily, spending at least 30 minutes each. This allows patients to get same-day or next-day appointments and easier access to advanced tests and screenings. Furthermore, patients can spend the necessary time discussing results and developing a personalized care plan with their doctor.

The Pros and Cons of Concierge Medicine

There are both benefits and drawbacks to the concierge medicine model.

Pros:

  • Guaranteed access to care 24 hours a day, seven days a week
  • We offer appointments on the same day or the next day.
  • Routine care such as wound treatment, blood tests, physicals, and preventive screenings are all done in-office.
  • No out-of-pocket costs for office visits!
  • Some common medications can be picked up from the office at a discount!

Cons:

  • Even if you have a health insurance plan, there are some services that it may not cover. For example, you may still need to pay out pocket for hospitalization and specialty referrals.
  • The cost of membership and monthly fees at different practices can vary greatly.
  • As you age, your fees will increase.
  • The cost of monthly fees and regular insurance premiums can be a burden for many people.

How Much Does Concierge Medicine Cost?

The cost of joining a healthcare practice can vary widely depending on your location and the specific organization. For example, at Southlake Pain Relief, initiation fees start at $60, and monthly membership dues range from $30 to $125, depending on the patient’s age. The group also offers family memberships with monthly fees calculated by age but limited to $200 a month.

“The move to entirely membership-based direct primary care in 2013 has opened up a lot of choice and affordability for people,” says Dr. Eric. “Now, over 1,500 practices across 48 states, and it’s become a much more viable option for people.”

Is It Covered By Insurance?

The monthly fee for the basic concierge or direct primary care is an out-of-pocket expense. You may incur additional fees for services such as outside labs or executive health assessments, depending on your specific care needs. Your health insurance company may reimburse some of these costs if the physician is considered an out-of-network provider. However, you may have to pay more if you see an out-of-network provider.

Concierge care is not a replacement for health insurance—you will still need the policy to cover hospitalizations and specialty referrals. However, since routine care is included in your membership, you may be able to save money by switching to a high-deductible health plan. Contact your benefits representative or health insurance company to determine what medical expenses your health savings account (HSA) or flexible spending account (FSA) can cover.

How to Decide if Concierge Medicine Is Right for You

How to Decide if Concierge Medicine Is Right for You

How to Decide if Concierge Medicine Is Right for You

Not all concierge medical practices are the same, so before deciding, identify the essential services to you and ask yourself if the procedure can provide them.

  • Can I afford to pay a monthly fee on top of my insurance premium?
  • How unimportant is it to have 24/7 access to a physician?
  • Do I have any chronic conditions that will require me to see specialists? If so, can I expect to get my money’s worth out of concierge care?

How to Find a Concierge Doctor

How to Find a Concierge DoctorHow to Find a Concierge Doctor

How to Find a Concierge Doctor

A simple online search should be your first step when looking for a concierge doctor. You’ll likely find many options to choose from. Be sure to visit each practice’s website, schedule a free consultation, and ask about their practice model before making your final decision.

Also, see if any of your friends or family members have concierge medical services. Ask about their experiences and if they would recommend the practice they use.

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