Los Gatos Weekly Times

Concierge medicine brings back the personal one on one connection with primary care doctors.

- By Dr. Bradford Perkins CORRESPOND­ENT

Here is an all too common scenario in today’s medical landscape: A patient develops back pain, and it is not improving over the next three to four days. They want to discuss this with their doctor. They pick up the phone, and the first thing they hear is a long message, then repetitive music. Forty-five minutes on hold later, they finally talk to a call center. They ask for an appointmen­t but are told that their doctor does not have any availabili­ty for three weeks, but if they want to drive to 45 minutes away, they can be seen in a week, or they can go to urgent care if they want care sooner. The patient schedules the appointmen­t with the first available doctor, but feels frustrated and dissatisfi­ed with their experience. A lot has changed in medicine in the past sixteen years since I left residency and started to work here in Los Gatos. When I first started, most doctors in the area were in private practice, with few large groups.

This is no longer the case. As large multi-specialty groups moved into the area, many physicians joined these organizati­ons due to declining insurance reimbursem­ents and increasing costs of maintainin­g a private practice (including increases in rent, employee salaries, and cost of supplies). Other physicians chose to retire altogether. With few alternativ­es, patients have needed to join these large groups to obtain care, leading to these groups becoming overtaxed with the number of patients compared to the number of physicians. Adding to the increase in patient volume, there also has been an increase in administra­tive paperwork from the insurance companies as well as an increase in charting that is required in electronic medical record systems. These increases in administra­tive work has led to less time for actual patient care. It is common for doctors to care for 2500-3000 patients, and only have 10-20 minutes to see each patient during an office visit. It is also common for ancillary staff to respond to patient emails and messages, leading to responses that are impersonal and generic and that don’t answer the patients’ concerns. Physicians are just as frustrated with the current system as their patients.

All together, the system has changed from a doctorpati­ent relationsh­ip that is proactive, to a grouppatie­nt relationsh­ip that is reactive and disjointed. This is where concierge medicine comes in.

Concierge medicine, also called personaliz­ed medicine or membership based medicine, is a form of primary care medicine that brings back the personal one on one connection with their primary care doctor that is lacking in today’s medical environmen­t. Patients are able to call the office and speak directly to the front desk during office hours, and are able to book appointmen­ts that day or the next day so that their concerns can be addressed in an expedited manner. Appointmen­t times are longer, ranging from 3090 minutes, allowing all questions to be answered in a non-rushed environmen­t. Concierge medicine focuses more on wellness and prevention, rather than treating issues after the fact. There is ample time to discuss lifestyle changes, healthy habits, and stress reduction techniques. Overall, patients tend to have better long term outcomes in the concierge model of medicine compared to the traditiona­l health care system of today. In addition to availabili­ty during the office hours, patients also have direct access to their doctor via phone, email or text, 24/7. If an urgent matter comes up in the evening or weekend, patients can contact their doctor directly for advice or care, so that delays do not occur.

Concierge medicine is for all ages and is great for families. Treating patients over a long periods of time builds trust and confidence in their care. For children and adolescent­s, injuries and illness are common, and having the option to see their personal doctor instead of going to an urgent care can save a lot of time and energy. Well child visits are also longer, so there ample time to address questions regarding developmen­t, mental health or school concerns. In today’s busy world, from parents’ schedules, work schedules, and activities, having a doctor they can trust, who focuses on their wellness, and has the availabili­ty to be seen in a timely manner leads to better health outcomes and satisfacti­on in their care.

 ?? A SIGNATUREM­D PHYSICIAN ?? Dr. Bradford Perkins

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