We came across a contributed post on Dr. James Diamond’s blog (Diamond is founder/CEO of Diamond Luxury Healthcare, a concierge medical network). The post is called “Is Concierge Medicine The Correct Choice For You?” and was submitted by contributor Paul Hsieh, MD. You’re well aware that our branch of concierge medicine, direct care, is carving out a niche where families, individuals, and businesses can get quality care for the most affordable rate possible. Although our society is made of many types of cars, some are more expensive than others, though. So it makes sense that our movement would see cost stratification.
In the long run, preventative care and smart business can have tremendous impact on our nation’s health and well-being. We’re not dismissing insurance and specialists, or doctors who provide premium services. But we do believe that the current healthcare landscape puts certain people at a severe financial advantage, one that ensures the top player’s success even when no “healthcare” has been administered. A case in point here would be an individual with a PPO who, though insured, opts out of seeing a doctor for something minor because their plan only covers them after a deductible is met. Say they were healthy all year, they might not be willing to spend an additional $50-$150 after paying their monthly premiums. Granted, if they were in a serious accident or developed a chronic condition they do have an advantage over someone who is uninsured (seeing an in-network doctor versus going to a county hospital, for example). Still, the insurance company wins here, and they didn’t do anything. In fact, they put the patient in a weak position where they have to choose if it’s worth doling out more money for a benefit.
And given the current state of fee-for-service medicine, it’s no surprise that some patients don’t want to see a doctor if they don’t absolutely have to. And it’s waiting till you absolutely have to that costs patients more money in the long run.
We believe that our theoretical individual would win if they instead followed our direct care model. The alternative wrap-around insurance premium would be much lower than a PPO, and they could use the difference to join a clinic like Atlas MD for $50/month. If they had a minor problem, they could see us right away instead of opting out of care. Seriously, how many people have you seen with minor breaks and sprains who’ve let these injuries heal themselves? We’ve seen plenty. And while yes, the human body is remarkably resilient, there’s no reason that care shouldn’t be attainable to the majority of the population.
Paul Hsieh, MD writes about the mutual benefits of concierge medicine in his blog post, saying, “Concierge physicians routinely report greater job satisfaction, because they can practice the way they were trained — taking the time to really talk to their patients and use their skills to their fullest extent.” He then discusses the reasons that Dr. Floyd Russak, the head of his county medical society, switched to a concierge practice. Russak says,
“It is morally wrong to practice inferior care… [I]t is just not practical to provide good care to patients in the current reimbursement model without maintaining a full-time practice of nearly 2000 patients, which requires 10-15 minute appointments to see everyone. Good care requires time, and with the overhead of a primary care practice running $200K/year per physician, time and reimbursement are at odds with each other…”
Russak takes it a step further than we have. Never have we argued that to NOT switch to direct care is to be morally abject, though. Let’s just say we’re glad to not have to consider the alternatives, the rushed visits, the hours negotiating for payment through third-parties. Although, if you take the moral pressure to transition to cash-only medicine off the table you still have the financial motivations. A recent study published by the concierge medical group MDVIP in the peer-reviewed American Journal of Managed Care showed that their approach to primary care saved $2,551 per patient due to decreased hospitalizations, and resulted in a 72-79% reduction in hospital readmissions for serious illnesses.
There’s nothing bad with that. So, yes, cash-only medicine might have different visions. But we see them as different sides of the same prism, one reflecting lights towards definite healthcare, not the expensive possibility that you might get it.Tweet