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Question DetailsAsked on 8/18/2011

My primary care doctor is going to a fee based concierge type practice. What is your take on this type of medical practice?

My doctor is going to a fee based concierge type practice. His practice will be limited to 450 patients who will pat 1650 per year to have 24/7 exclusive access to him. Medicare or my supplement does not pay this fee. Only see 20 drs in the Houston area who are members of this
MD VIP organization, and only four reviews. What's your take?

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4 Answers


Excellent question! The Angie's List Magazine did some research on this type of care a few years ago. Here's one of the articles on concierge care and Angie also wrote her column on it.

Answered 9 years ago by Cas


Depending onwhere you live, there are a lot of these practices especially in the West. Inparts of the country it can be difficult to find a physician that takestraditional insurance and especially hard to find one that takes a governmentalform of insurance. Some physicians are grandfathering in some patients so thatpeople are not left without the provider that knows them best. Others aredismissing anyone unwilling to convert from their practice.

I think in the right market it makes to pay for a high quality provider, andthen also pay an insurance premium for emergency and catastrophic coverage. Theimportant things to look at and ask about are how they compare to standards ofcare. "What % of your patients with diabetes have an A1c < 7%?""What % of your patients with diabetes and applicable heart issues have aBP < 130/80?"

There are a number of measures called the HEDIS measures that insurancecompanies hold physicians to because of the preventative nature of these goals.While the measures on a population base help extend people's lives, and keepthem out of the hospital, it is important that a physician looks at theindividual and rationalizes when the HEDIS measures do not apply. In aconcierge practice, they will have no over sight on how they practice - this ispart of the appeal. They may charge you to do paperwork and have many separatecharges outside their base fees, consider these carefully.

Theconcierge service is purposefully trying to avoid the insurance payment system.With your insurance company you can call Customer Service and ask if you cansubmit these visits as "out of network" to at least get a portionpaid for. But with the flat fee for service approach this will be challenging. If they have a base fee and then added use fees, it would be easier to getit partly paid for by you submitting the paperwork.

Best of luckand good health to you.


Answered 8 years ago by PMcCauley


It's the current future of health care. Pay cash for care or have gov't insurance. Cash=care. Obamacare=insurance.

I've been using this type of MD for about 10-12 yrs and I love it. He knows me, I can talk to him about anything. I can see him that day if I want to and he calls in prescriptions in the evenings or weekends if I forget refills during the week or a new symptom emerges that he can take care of w/o seeing me. I've never felt healthier mentally and physically in my life. (We do have a FP here in town we see occasionally and maintain a relationship with in case we need hospitalization.

Source: http:// RN in TN

Answered 7 years ago by wendybTn


MDVIP patients get an very comprehensive physical exam that goes far beyond the "basics" that the standard health-cost-containment/crisis-management plan (often euphemistically referred to as "health insurarance") doesn't include. Many of the tests, screens, and other reviews help the doctor and patient evaluate the current condition as well as help map out a reasonable plan of action for preventative measures.

The current US insurers do not pay adequately for a primary care physician to spend the time and quality focus on patients to throroughly explore their history and possible related causes. Instead, it virtually mandates a burger-joint grill'em-and-bill'em process that gets the most patients through in as short a time as possible and minimize the potential for finding other health issues that might then require the insurer to pay for additional health treatments. Additionally, insurers put up as many roadblocks as possible (think of prior authorizations, step-up medication process, denials, etc.) that reduce the doctors' pay and even cause their staff additional paperwork and labor overhead at no compensation.

Doctors and their staffs are more than willing to do the patient care steps, but the office must be able to operate at a profit: the MDVIP allows that to happen, with a smaller more manageable patient base, and allows the doctor to regain control of treating patients comprehensively.

Peer reviewed studies have also shown that these patients have fewer illnesses, shorter illness periods, and fewer "bounce-backs" to the hospital than similar groups of patients ~ this is because of the forward-looking approach the doctor has to caring for the patient. In many cases, this also results in lower costs (and especially inconvenience and lost time) for the patients that FAR outweighs the annual costs of participation ... not to mention the peace of mind.

My wife is a physician transitioning to the MDVIP model. I have been speaking to her patients for years and this is what her patients are telling me about why they have decided to follow her in this model. She sees this as a great opportunity to allow her to practice MEDICINE and CARE the way it should be as agreed between her and the PATIENT, and not as a cost-managed limited-care option controlled by the insurers.

Answered 4 years ago by CBThayer

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