Will Patients Pay for Concierge Medicine?

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In exchange for a membership fee, patients can receive round-the-clock physician access, same-day appointments, personalized health plans and longer office visits. But in a down economy, physicians considering concierge medicine must wonder if their patients are willing to pay a fee beyond their regular insurance coverage.

Recent coverage of concierge medicine indicates the answer is yes. An August editorial in The New York Times revealed the number of physicians practicing concierge medicine has increased from 200 in 2003 to around 5,000 today. A study published in The Patient: Patient-Centered Outcomes Research showed while physician-patient relations are relatively similar in concierge practice and general medicine practice, concierge medicine patients are more likely to report that their physician spends sufficient time in clinical encounters.

As the 2011 influx of newly insured patients approaches, Wayne Miller, JD, with Compliance Law Group, says, "In this economy, are people still willing to pay a fee beyond what they would be paying for insurance coverage? That's really a big question because people can't always afford it, so the critical issue is: what is being offered, and how much is it worth?"

Mr. Miller says patients with modest insurance coverage might be particularly drawn to concierge medicine because it offers "increased access, more education, online care and many other features that may not be paid for by insurance." He says he has seen concierge practices align themselves with high-deductible plans. If patients take a plan that has a low premium and a high deductible, concierge physicians may be able to save the patient money be identifying problems before they require an expensive treatment. "The thought is, I can help you stay healthy so you can maintain this plan and not pay so much out of pocket," Mr. Miller says.

Mr. Miller says concierge medicine might also attract physicians who would like to use more technology in their practice. "There are some physicians who want to use online medicine to help their practice, but to do that, they feel they need to have a different kind of patient base or a patient base that's in tune with technology," he says.

Physicians with a majority of patients on fixed incomes might have less to gain from concierge services, as well as physicians whose patients visit infrequently. "If you have a lot of older or HMO patients, you have to expect you will lose some of the patient population who won't be willing to pay, whether or not it's a great thing for the patients," he says. Physicians may also need to terminate existing relationships with payors who won't allow the physician to collect additional payments.

Physicians who have experienced the move to concierge medicine agree that it's not for everyone. A 2010 article in Kansas' Wichita Eagle interviewed Aly Gadalla, MD, an internal medicine physician who chose to convert part of his practice to concierge medicine. For $2,500 a year, he gives patients 24-hour-a-day access, his cell phone number, same-day appointments and care that isn't dictated by third party, according to the report.

Instead of the 2,500-3,000 patients the average physician sees, however, Dr. Gadalla limits his practice to around 250. He said the switch isn't for every physician, just a certain sector of the population.

Mr. Miller says he believes the growth will continue as some physicians feel overburdened by patient load and financial stress. "Many physicians prefer the practice of medicine that focuses on preventative care and education, and its' not just feasible [in a general practice environment] to provide a fuller, holistic version of medical care," he says. "And there are many physicians who don't want to be tied down to the traditional bricks and mortar kind of arrangement."

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