Written by Andy Oakes-Lottridge Special to news-press.com
FEBRUARY 10, 2014 - As my patients can tell you, I’ve recently been happy to announce my transition into group practice with two wonderful doctors here in Fort Myers. This has led to lots of questions from my current patients. Can it still be concierge medicine if I’m asking patients to come see me in an office? Better yet, what exactly is concierge medicine?
To further complicate the answer to those questions, the practice model I continue to follow is sometimes called direct practice or private-pay medical practice. While there is large variation among practices like ours, there are some basic similarities.
First started in the early 1990s in Seattle, it was pioneered in Florida in 1998 by my partner Dr. Gary Price, who is also the current chairman of the board and past president of the American Academy of Private Physicians. Concierge medicine is “expanding exponentially because it’s a better system… because it restores the doctor-patient relationship… it gets the third party payer out of the way and removes the doctor’s conflicts of interest because he is being paid only by the patient. Direct practice means there is a direct financial relationship with patients and with nobody else. We are not bound by government or insurance companies telling us how to treat patients,” Dr. Price says.
Since 1998, concierge medical practices have grown. Doctors don’t bill insurance for services. Instead, patients pay a retainer, typically $100 to $350 or more a month. In return, doctors provide primary care services and agree to limit their patient load to 300-800 patients. This allows doctors to have fewer patients and still remain profitable. It also allows some doctors to provide other services, since each practice may offer services in a slightly different manner. Some, like my old practice, may exclusively do home visits, or offer pediatric services as well. Others, like my current practice, offer home visits but primarily offer medical services in an office setting.
What services are provided? This requires a full disclosure and thorough conversation between all prospective patients and the physician. Some practices also will bill your insurance in addition to charging a fee. The basics usually include: office and home visits, around-the-clock access by phone and email, same-day appointments, personally coordinating specialty care, and providing bedside attention in the hospital.
Concierge medicine has drawn aggressive objections from some health care ethicists and economists who warn that it could widen the gap in access to medical care between the rich and poor. These fees are not typically covered by insurance. Another argument against concierge practices has been that as more of my colleagues follow our lead, fewer will be available to see the majority of patients who may not be able to afford our services.
While I don’t have the answers to these concerns, there are some important points worth making. In its policy statement on concierge medicine, the American Medical Association makes clear the responsibility that all physicians have to their community. I personally enjoy volunteering at the Senior Friendship Centers Clinic and serving as an officer in the Army National Guard.
— Andy Oakes-Lottridge, MD, FAAFP, with Private Physicians of South-West Florida. Email: Andy@DrAndy.US or call 239-415-1111.
