At Your Ser­vice

An up­date on medicine in Amer­ica

RSWLiving - - Department­s - WRIT­TEN BY GARY M. PRICE, M. D., F. A. C. P.

In re­cent years, news sto­ries about med­i­cal prac­tice in Amer­ica have been mostly neg­a­tive. They have a point. Our re­im­burse­ment sys­tem has in­cen­tivized— in­deed, forced— doc­tors to see more and more pa­tients each day to re­main sol­vent. To see more pa­tients, doc­tors have had to work faster to re­duce the du­ra­tion of vis­its, which now av­er­age a mere seven min­utes each!

The av­er­age Amer­i­can pri­mary- care doc­tor serves about 4,000 pa­tients. Since quan­tity and qual­ity are in­com­pat­i­ble in med­i­cal prac­tice, this in­crease in vol­ume has re­sulted in a pre­dictable de­crease in qual­ity, with an at­ten­dant de­crease in sat­is­fac­tion for both pa­tient and doc­tor. “Oba­macare” will only ex­ac­er­bate the prob­lem. So what are we to do? For­tu­nately, there is a so­lu­tion.

In the late 1990s, a new move­ment was born si­mul­ta­ne­ously in Fort My­ers, Florida, and Seat­tle, Wash­ing­ton. Cre­ative physi­cians, dis­sat­is­fied with the sta­tus quo, opted out of the insurance- based med­i­cal sys­tem to in­vent a bet­ter way of serv­ing their pa­tients. They re­duced their panel size to a few hun­dred in­stead of sev­eral thou­sand pa­tients, in­creased the length of vis­its to thirty min­utes or more, and es­tab­lished di­rect fi­nan­cial re­la­tion­ships with their pa­tients to elim­i­nate con­flicts of in­ter­est and to re- em­power pa­tients. This move­ment came to be known as “concierge prac­tice” and is some­times also known as “di­rect prac­tice,” “pri­vate prac­tice,” or “bou­tique prac­tice.”

In just fif­teen years, this move­ment has grown from a cou­ple of out­ly­ing prac­tices in op­po­site cor­ners of the coun­try to thou­sands of main­stream ones through­out the land. To­day, even med­i­cal schools are in­clud­ing “pri­vate medicine” in their cur­ric­ula, giv­ing med­i­cal stu­dents a vi­able path- way to a ca­reer in pri­mary care, which was all but nonex­is­tent. As the mo­men­tum con­tin­ues to build, what ac­counts for the ex­plo­sive growth? It’s sim­ple: concierge medicine is a bet­ter model.

Concierge medicine re­stores the doc­tor­pa­tient re­la­tion­ship to the lofty level it en­joyed be­fore be­ing con­strained and de­graded by gov­ern­ment and insurance. Concierge physi­cians work only for the pa­tients. We give them un­com­pro­mis­ing care in an un­hur­ried, re­spect­ful set­ting. Be­cause we care and have no con­flicts of in­ter­est, the physi­cian be­comes a trusted friend.

Imag­ine be­ing able to call your doc­tor at any time on his or her cell phone if you have a ques­tion, or be­ing able to sched­ule an of­fice visit “to­day” if you need it. How about a house call if you are un­able to go to the of­fice? Imag­ine hav­ing your doc­tor guide your care through the com­plex maze of spe­cial­ists and hos­pi­tals, se­lect­ing only what is best for you with no com­pro­mises or ex­cuses. That is the world of pri­vate ( concierge) medicine. Mar­cus Welby, M. D.


is alive and well!

Con­trary to pub­lic opin­ion, concierge medicine is less ex­pen­sive than to­day’s stan­dard medicine. Be­cause we em­pha­size preven­tion and have time for proac­tive care, our pa­tients en­joy much lower rates of hos­pi­tal­iza­tion and emer­gen­cy­room uti­liza­tion, which saves the sys­tem money— a lot of money. Our prod­uct is good health, and healthy peo­ple are in­ex­pen- sive in re­gard to their care.

Concierge medicine is blos­som­ing be­cause it is a bet­ter model for med­i­cal prac­tice. It re­stores the doc­tor- pa­tient re­la­tion­ship, re­sponds to needs of the mar­ket, solves the mal­prac­tice li­a­bil­ity cri­sis ( data show that concierge doc­tors don’t get sued), and reins in waste­ful spend­ing that is bankrupt­ing the sys­tem. So, the prog­no­sis for health care in Amer­ica is ex­cel­lent. Thanks to pri­vate medicine, out­stand­ing health care will con­tinue to be avail­able, and the fu­ture looks bright for both pa­tient and doc­tor alike.

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