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Concierge Medical Care System

by

Marvin Cole

This is primarily the result of high administrative costs and below expectation payout by insurance companies. In fact some are struggling to stay afloat because of this. This has resulted in quite a number of Physicians moving to a Concierge Medical Service model. Also, Patients assigned to Primary Care Physicians have to wait for hours and days before being able to get an appointment, that too for short time durations, with them. Concierge system of providing medical care is one in which a patient pays an annual fee or retainer to a primary care physician. Depending upon the agreement there may or may not be some additional amount charged.

This can come as a relief for people who have had to wait for weeks to see the doctor. For some additional fees, patients get the opportunity to enjoy same-day appointments with 24-hour access, get more time with the doctor and invest in extra preventative care. Although the broad factors remain the same, variants exist in terms of payment requirements, operation and structure. In this, the insurance companies are completely taken out of the loop and patients pay for the service that is rendered. Currently, the most common type of Concierge model in practice has physicians holding on to their traditional practice but charging an additional fees from a small group of patients who are then entitled to special treatment and services which are not otherwise covered by traditional insurance. The variant at the other extreme has the physicians cancelling relationships with Medicare, Medicaid and insurance carriers. They build their practices aimed exclusively for patients willing to pay a retainer fees. The amount paid as retainer depends entirely on the range of services a particular patient wants to cover. Generally these patients carry insurance cover for all those types of services which are unavailable with their concierge physicians.

It enables physicians to focus more on their patients, spend more time on them rather than having to deal with the payment issues which generally arise out of handling insurance companies. Also, the physicians are absolved of being influenced by the insurance companies changing their ways of practice or suggesting what drugs to suggest, etc. They now have to decide on the number of patients they would like to attend to and do everything they possibly can to provide them with the best of care. The patients on their part however are responsible for prescription drugs and other ancillary medical devices and testing. Patients are required to use their insurance to pay for visits to specialists and hospitals. Many feel that this approach is going to lead to a two-tiered health-care system – one in which the rich will get preference for care over the ones who are not financially at par. There is also another problem likely to arise. Because of the inherent nature of the model, physicians will be required to reduce the number of patients they can handle which over a period of time, if the system gets widely accepted, will lead to a dearth of primary care physicians.

Besides this, Affordable Care Act will compel approximately 30 more million people to be insured. This again will lead to a demand for PCPs. So there is a high possibility of the overall healthcare system taking a hit because it widespread use of concierge practice will mean that more and more people, esp. with lower income levels, will be left without any access to primary care. Presently, the number of physicians who have chosen to adopt this new model is very low. For the model to succeed it has to be gain acceptance from a bigger and wider audience. There are some physicians who are moving to a model with the intent of directing their focus is entirely towards wealthy patients. Besides visiting them at their homes they also accompany them to the specialists.

In all such situations, online applications which impart healthcare services or at least assist the physicians in servicing patients are picking up steam. Needless to say, healthcare software testing also has to be done to ensure the effectiveness of the systems are maintained.

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