Growing up, my entire family went to one local family physician. That doctor gave my mom medical care when she was pregnant, delivered me when I was born, gave school shots, wrote prescriptions for any virus that came up, and helped my grandparents with geriatric care. A well rounded, down to earth physician who managed our overall health at each stage of life.
When she retired, she transferred her patients over to a new local doctor starting out. His office fielded all the same responsibilities our original doctor took care of. The difference was, now there were nurse practitioners who took on the lions share of seeing patients. We very rarely saw the doctor himself, and honestly, it was not a problem. The nurse practitioners, in most situations, knew how to take care of the basics, and get us to specialists if we needed them. This is where my family has received their care since the 1980s.
My childhood town has changed in the last thirty years. It used to be a small community that had all the basics and not too much fluff. Then came the day when the town showed up on a national list as one of the top places to raise children. All of a sudden, my small town turned into an affluent community with expensive specialty stores, high end eateries, and all the arrogance money can buy. The "been there for 200 years" town folks, including my family, are still there, though not as prevalent. The town has little collective memory of the charm it once possessed without all the added expense. I think this is why that town was a perfect target for the burgeoning concierge medicine model.
With all the wealth of the town, and an aging population, there is a tendency for people to be afraid of change. The Affordable Care Act, and the debates around it, scared the heck out of many older folks. Especially the folks who stuck to only one or two news sources, and never met anyone who struggled with insurance coverage. "If it ain't broke, why fix it?"
What many people did not understand was that a lot of the fear mongering about Obamacare, was based in political rhetoric and insurance share holder worries. Publicly traded health insurance companies had a financial interest for things to remain as they were. The push back had little to do with people having access to their doctors, and more to do with where the money would fall.
So, back in my home town, in walks a company offering a concierge medicine setup for my family's doctor. All the doctor needs to do is choose 600 select patients from his client list, and those people buy into a VIP program. The program costs about $1,600 a year per person (that varies from state to state). The basic breakdown is that $1,000 goes to the doctor, and $600 goes to the company setting up the concierge service. The patients who shell out the cash upfront, can continue to see their doctor. Those patients are special, because others have not been given the opportunity to join the "club" and therefore must find a new general practice physician.
Here's the important part though; What kind of treatment do the VIP patients get for the extra money they pay? The answer is, the exact same coverage they are entitled to through their regular insurance policy that they have already purchased. From the doctor's point of view, this concierge service allows them to have less clients to care for, without losing income, and that is nice for them, but it doesn't change much for their select patients. Should my parents choose to buy in to this system, my mother will still only see the nurse practitioner once a year for her annual physical, and my father will still avoid going to the doctor altogether unless something is broken. For an average individual, it makes more financial sense to switch doctors than join the "club."
For me, I think concierge medicine has its place. It makes sense when there is universal health care coverage in a country, and everyone is treated exactly the same. In that system, if someone would like a little extra attention, concierge medicine is a perfect fit. Here in America, we do not have universal health care, we have private insurance with different levels of coverage a person can purchase to fit their needs. Private insurance should be our "concierge medicine" because we are paying for it in the same way other countries would pay for additional coverage beyond universal care.
It seems to me, concierge medicine within the American health care system is essentially paying two companies, for what one already entitles you to have. I can not tell someone if concierge medicine is worth it. Everyone has their own opinion, and the choice is yours. However, I would encourage everyone to do some major research on the topic, if the option is given to you.
I do wonder if concierge medicine becomes more prevalent, how that will impact those who could never afford $1,600-a-year above their health insurance plans. That is something we will have to watch.
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