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Fairfax Underground
Welcome to Fairfax Underground, a project site designed to improve communication among residents of Fairfax County, VA. Feel free to post anything Northern Virginia residents would find interesting.
Welcome to Fairfax Underground, a project site designed to improve communication among residents of Fairfax County, VA. Feel free to post anything Northern Virginia residents would find interesting.
McLean doctor says ‘concierge medicine’ is future of primary health care
Posted by:
Interesting Idea
()
Date: March 14, 2014 07:15AM
McLean doctor says ‘concierge medicine’ is future of primary health care
Instead of paying with insurance, patients pay annual membership fee
http://www.fairfaxtimes.com/article/20140312/NEWS/140319697/1117/mclean-doctor-says-x2018-concierge-medicine-x2019-is-future-of&template=fairfaxTimes
In two weeks, McLean internist Dr. David J. Jones will be taking a giant occupational leap.
“As of April 1, I will no longer be accepting medical insurance,” he said. “That’s it.”
Jones is one of a growing number of doctors who are becoming increasingly frustrated with what they say is an inefficient primary care health system, and who are moving away from the traditional health care model into what is called “concierge medicine.”
Also known as “boutique medicine”, “retainer-based medicine” or “innovative medical practice design,” concierge medicine physicians charge their patients a one-time annual membership fee which is paid out-of-pocket instead of billing insurance companies for individual visits. Currently, the annual fee for patients in Jones’ Principal Medical Group is $2,000 for an individual and $3,000 for a couple.
“This fee enables doctors to limit the number of patients they see on a daily basis, allowing for a level of personalized care for patients often not possible in a traditional practice,” he said. “The average primary care physician has a typical roster of between 3,500 to 5,000 patients. On average, Americans spend 23 minutes in their doctor’s waiting rooms and only 19 minutes with the doctors themselves.”
There were about 4,400 concierge medicine physicians in the U.S.in 2012, a 25 percent increase from 2011, according to information from the American Academy of Private Physicians. Averaging roughly 350 patients per concierge doctor, the academy estimates there are probably nearly 2 million million Americans currently under the care of a concierge medicine physician today.
Jones argued that with physicians struggling to keep up with unmanageable patient bases, increasingly bureaucratic reimbursement issues and labor-intensive administrative chores, many don’t have the time to truly get to know their patients and treat them as individuals.
“And justifiably, patients are becoming increasingly frustrated with the impersonal service and time spent waiting, rather than their doctors actually working on preventing and caring for them,” he said. “On the other hand, with only 350 or so ‘membership’ patients, I can spend 30 minutes to an hour with each one, and get to really know each person as an individual. My patients can also call me anytime, after hours, weekends, while I’m on vacation, if they need a prescription refill, whatever.”
According to Dr. David Fein, an internist who in late 2012 opened a branch of the Princeton Longevity Center in Fairfax, current health care reform is only adding to an already overtaxed medical system.
Like Jones, Fein does not participate in any insurance plans.
“With health care reform, uninsured patients will no longer use emergency rooms as their primary care and instead will begin to flood the offices of primary care physicians, who will see vastly increased numbers of patients,” Fein said. “But reimbursement rates will also be less, so physicians will need to see more patients to remain where they were before financially.”
Fein said that as traditional primary care physicians see higher numbers of patients, the average time that most physicians will be able to spend with each patient — currently estimated by Jones to be 19 minutes nationwide — could shrink to less than five minutes.
“What I’m doing now is just what doctors used to do years ago,” Jones said. “Charging patients a fee for medical services and leaving everyone else out of the equation. I think you may soon see many physicians returning to that model.”
Jones has written a 25-page e-book on the subject, titled “Achieving Individualized Healthcare through Concierge Medicine,” in which he outlines the concept and its advantages. “It is not an advertisement for me or my practice,” he said. “It just explains more about the general concept.”
The e-book can be downloaded for free from iTunes, or at Amazon.com for a 99-cent download fee.
Principal Medical Group’s Dr. David Jones is among a growing number of “concierge” medicine physicians who charge their patients a one-time annual membership fee instead of billing insurance comnpanies for individual visits.
Attachments:
Instead of paying with insurance, patients pay annual membership fee
http://www.fairfaxtimes.com/article/20140312/NEWS/140319697/1117/mclean-doctor-says-x2018-concierge-medicine-x2019-is-future-of&template=fairfaxTimes
In two weeks, McLean internist Dr. David J. Jones will be taking a giant occupational leap.
“As of April 1, I will no longer be accepting medical insurance,” he said. “That’s it.”
Jones is one of a growing number of doctors who are becoming increasingly frustrated with what they say is an inefficient primary care health system, and who are moving away from the traditional health care model into what is called “concierge medicine.”
Also known as “boutique medicine”, “retainer-based medicine” or “innovative medical practice design,” concierge medicine physicians charge their patients a one-time annual membership fee which is paid out-of-pocket instead of billing insurance companies for individual visits. Currently, the annual fee for patients in Jones’ Principal Medical Group is $2,000 for an individual and $3,000 for a couple.
“This fee enables doctors to limit the number of patients they see on a daily basis, allowing for a level of personalized care for patients often not possible in a traditional practice,” he said. “The average primary care physician has a typical roster of between 3,500 to 5,000 patients. On average, Americans spend 23 minutes in their doctor’s waiting rooms and only 19 minutes with the doctors themselves.”
There were about 4,400 concierge medicine physicians in the U.S.in 2012, a 25 percent increase from 2011, according to information from the American Academy of Private Physicians. Averaging roughly 350 patients per concierge doctor, the academy estimates there are probably nearly 2 million million Americans currently under the care of a concierge medicine physician today.
Jones argued that with physicians struggling to keep up with unmanageable patient bases, increasingly bureaucratic reimbursement issues and labor-intensive administrative chores, many don’t have the time to truly get to know their patients and treat them as individuals.
“And justifiably, patients are becoming increasingly frustrated with the impersonal service and time spent waiting, rather than their doctors actually working on preventing and caring for them,” he said. “On the other hand, with only 350 or so ‘membership’ patients, I can spend 30 minutes to an hour with each one, and get to really know each person as an individual. My patients can also call me anytime, after hours, weekends, while I’m on vacation, if they need a prescription refill, whatever.”
According to Dr. David Fein, an internist who in late 2012 opened a branch of the Princeton Longevity Center in Fairfax, current health care reform is only adding to an already overtaxed medical system.
Like Jones, Fein does not participate in any insurance plans.
“With health care reform, uninsured patients will no longer use emergency rooms as their primary care and instead will begin to flood the offices of primary care physicians, who will see vastly increased numbers of patients,” Fein said. “But reimbursement rates will also be less, so physicians will need to see more patients to remain where they were before financially.”
Fein said that as traditional primary care physicians see higher numbers of patients, the average time that most physicians will be able to spend with each patient — currently estimated by Jones to be 19 minutes nationwide — could shrink to less than five minutes.
“What I’m doing now is just what doctors used to do years ago,” Jones said. “Charging patients a fee for medical services and leaving everyone else out of the equation. I think you may soon see many physicians returning to that model.”
Jones has written a 25-page e-book on the subject, titled “Achieving Individualized Healthcare through Concierge Medicine,” in which he outlines the concept and its advantages. “It is not an advertisement for me or my practice,” he said. “It just explains more about the general concept.”
The e-book can be downloaded for free from iTunes, or at Amazon.com for a 99-cent download fee.
Principal Medical Group’s Dr. David Jones is among a growing number of “concierge” medicine physicians who charge their patients a one-time annual membership fee instead of billing insurance comnpanies for individual visits.
Attachments:
Re: McLean doctor says ‘concierge medicine’ is future of primary health care
Posted by:
HW4Uw
()
Date: March 14, 2014 12:32PM
Legally speaking, how could doctor's do this? Not accepting a patient's health insurance?
Re: McLean doctor says ‘concierge medicine’ is future of primary health care
Posted by:
eLester
()
Date: March 14, 2014 02:54PM
Out of network.
Re: McLean doctor says ‘concierge medicine’ is future of primary health care
Posted by:
F7vHC
()
Date: March 14, 2014 03:00PM
means he has a contract with the county
like so many dentists in vienna
some of who, btw, got free grant money to start the practice
AND ARE NOT CITIZENS of the usa
fuck you too
no doubt the school he went to did get tax dollars
---------------------------
we'll see his worth in if he ever does work that isn't gravy
i very much doubt it
like so many dentists in vienna
some of who, btw, got free grant money to start the practice
AND ARE NOT CITIZENS of the usa
fuck you too
no doubt the school he went to did get tax dollars
---------------------------
we'll see his worth in if he ever does work that isn't gravy
i very much doubt it
Re: McLean doctor says ‘concierge medicine’ is future of primary health care
Posted by:
eLester
()
Date: March 14, 2014 03:15PM
Doesn't he still have to submit paperwork to the insurance companies for referrals to specialists, orders for lab tests, and prescription refills? I don't expect healthy patients submitting to this arrangement.
Re: McLean doctor says ‘concierge medicine’ is future of primary health care
Posted by:
A Patient
()
Date: March 14, 2014 09:09PM
Wow. So much ignorance about how health insurance works. The following will be TL;DR but might shed some light. And I'm sure someone will take issue with something I'm about to write, so have at it!
There are two main flavors of health insurance, HMOs and PPOs, with lots of subtle variations.
Witha PPO, doctors contract with specific insurance companies. That means they "take" that insurance. They may or may not file the claims for you; many do, but not all.
Being contracted with an insurance company means that the doc agrees to take a contracted amount for services. Say the doc normally gets $125 for an office visit of some specific duration. THe insurance company says, "We'll pay you $60 for that. But you get to be in our network, and is nearby, so you'll get tons of customers from that." (In a small town, it can be quite cutthroat: "We employ 80% of the town, so if you don't take their insurance, you'll lose most of your patients".)
Adoc doesn't HAVE to be part of any networks, but most people who have insurance will avoid out-of-network doctors, since they'll get to pay the difference between whatever the insurance company will pay (less than that $60, likely, in this case) and the $125. So instead of that routine visit costing you whatever your copay is, in this case it'll be more than $65.
So with this "concierge" setup, docs may opt out of all insurance, or may continue to take insurance. In the latter case, they're sort of playing a game, charging a "concierge fee" for "extra services" that aren't tied to specific patient visits. This is an important distinction, because part of the deal with the insurance company is that the doc can ONLY collect the contracted-for amount. Otherwise sleazy docs (and I've seen this!) would take the contracted amount PLUS some or all of the difference, thus getting the benefits of the insurance network for free.
An HMO is actually more like the concierge idea, only en masse: a PCP (primary care physician) in an HMO is assigned a pool of patients, and paid a flat fee per month per patient. So they make the same whether it's flu season and the office is packed, or August and everyone is away at the beach and the office is empty.
As a friend puts it, "With a PPO, the doctor gets paid for seeing patients. With an HMO, he gets paid for NOT seeing patients".
HMOs (and some PPO variations) also require the PCP to refer patients before they can see specialists. This means that the insurance company may lean on them if they make too many referrals, which is one of the reasons that people often distrust HMOs. Of course it doesn't have to be that way, but it's a common perception.
In theory, HMOs are more efficient because they reduce patients self-diagnosing and running off to specialists for no good reason, and by having a "gatekeeper", there's a central point of control (so specialist A doesn't prescribe a treatment that conflicts with another doc's treatment, for example).
If you're young and healthy, an HMO thus may make more sense (since they're also generally cheaper). If you're older and want more control over your healthcare, a PPO may be more appealing. And again, there are tons of subtle variations.
Meanwhile, doctor Fein is kind of dissembling with:
“With health care reform, uninsured patients will no longer use emergency rooms as their primary care and instead will begin to flood the offices of primary care physicians, who will see vastly increased numbers of patients,” Fein said. “But reimbursement rates will also be less, so physicians will need to see more patients to remain where they were before financially.”
There's no evidence of any "flood" of patients; indeed, ERs can't handle patients as fast as a doctor's office, so at worst we'll probably see a small increase in demand for GPs. And specialists can spend more time in the office and less on duty at the ER, which should make them happy.
And why would reimbursement rates be less? That's just bizarre. Next thing Fein will be talking about how ACA "will limit care" -- as if the insurance companies haven't been doing that to an increasingly intrusive degree for the last couple of decades!
The sad part of it is that doctors want to be doctors, not businessmen. So having to decide what insurance to take and which not to take, and all of that, gets in the way of what they want to be doing. And if they wren't all just terrified by lots of noise--unsupported by the facts--about how they'll wind up in the poorhouse, they'd be leading the charge toward single-payer insurance.
There are two main flavors of health insurance, HMOs and PPOs, with lots of subtle variations.
Witha PPO, doctors contract with specific insurance companies. That means they "take" that insurance. They may or may not file the claims for you; many do, but not all.
Being contracted with an insurance company means that the doc agrees to take a contracted amount for services. Say the doc normally gets $125 for an office visit of some specific duration. THe insurance company says, "We'll pay you $60 for that. But you get to be in our network, and is nearby, so you'll get tons of customers from that." (In a small town, it can be quite cutthroat: "We employ 80% of the town, so if you don't take their insurance, you'll lose most of your patients".)
Adoc doesn't HAVE to be part of any networks, but most people who have insurance will avoid out-of-network doctors, since they'll get to pay the difference between whatever the insurance company will pay (less than that $60, likely, in this case) and the $125. So instead of that routine visit costing you whatever your copay is, in this case it'll be more than $65.
So with this "concierge" setup, docs may opt out of all insurance, or may continue to take insurance. In the latter case, they're sort of playing a game, charging a "concierge fee" for "extra services" that aren't tied to specific patient visits. This is an important distinction, because part of the deal with the insurance company is that the doc can ONLY collect the contracted-for amount. Otherwise sleazy docs (and I've seen this!) would take the contracted amount PLUS some or all of the difference, thus getting the benefits of the insurance network for free.
An HMO is actually more like the concierge idea, only en masse: a PCP (primary care physician) in an HMO is assigned a pool of patients, and paid a flat fee per month per patient. So they make the same whether it's flu season and the office is packed, or August and everyone is away at the beach and the office is empty.
As a friend puts it, "With a PPO, the doctor gets paid for seeing patients. With an HMO, he gets paid for NOT seeing patients".
HMOs (and some PPO variations) also require the PCP to refer patients before they can see specialists. This means that the insurance company may lean on them if they make too many referrals, which is one of the reasons that people often distrust HMOs. Of course it doesn't have to be that way, but it's a common perception.
In theory, HMOs are more efficient because they reduce patients self-diagnosing and running off to specialists for no good reason, and by having a "gatekeeper", there's a central point of control (so specialist A doesn't prescribe a treatment that conflicts with another doc's treatment, for example).
If you're young and healthy, an HMO thus may make more sense (since they're also generally cheaper). If you're older and want more control over your healthcare, a PPO may be more appealing. And again, there are tons of subtle variations.
Meanwhile, doctor Fein is kind of dissembling with:
“With health care reform, uninsured patients will no longer use emergency rooms as their primary care and instead will begin to flood the offices of primary care physicians, who will see vastly increased numbers of patients,” Fein said. “But reimbursement rates will also be less, so physicians will need to see more patients to remain where they were before financially.”
There's no evidence of any "flood" of patients; indeed, ERs can't handle patients as fast as a doctor's office, so at worst we'll probably see a small increase in demand for GPs. And specialists can spend more time in the office and less on duty at the ER, which should make them happy.
And why would reimbursement rates be less? That's just bizarre. Next thing Fein will be talking about how ACA "will limit care" -- as if the insurance companies haven't been doing that to an increasingly intrusive degree for the last couple of decades!
The sad part of it is that doctors want to be doctors, not businessmen. So having to decide what insurance to take and which not to take, and all of that, gets in the way of what they want to be doing. And if they wren't all just terrified by lots of noise--unsupported by the facts--about how they'll wind up in the poorhouse, they'd be leading the charge toward single-payer insurance.