4 ms·

You're describing (in a way) concierge medicine. Wikipedia has a rough description: https://en.wikipedia.org/wiki/Concierge_medicine https://en.wikipedia.org/w

You're describing (in a way) concierge medicine. Wikipedia has a rough description: https://en.wikipedia.org/wiki/Concierge_medicine https://en.wikipedia.org/wiki/Concierge_medicine Annual fees can run in the 10s of thousands of dollars but quality and access to care is top notch. An appropriate comparison would be flying Spirit vs private. It's such a different experience (and in the case of medicine - outcome) that it can hardly be called the same thing.

arkades 10y ago
Concierge access is a business model largely dependent on the SES of the community the doctor is located in, and his personal charisma/following. It's very, very poorly correlated to physician quality. Access tends to be a lot better, but only in those practices that are 100% cash. Those practices that try to "transition" or do a mixed customer base tend to be the same as all-insurance practices, since they fail to transition operations/processes towards the cash-based context.
- kkielhofner 10y ago
  I should have mentioned that my experience is highly anecdotal - a handful of patients across a couple of doctors. Yes, these practices are 100% cash. I noted several key differences: - Top-tier education. Medical school and residency at top 5 programs in the United States. - Availability. They have total patient rosters in the low-hundreds, and many of these patients are seasonal. Response was always same day and more often than not immediate (phone, text, e-mail). I got the sense I maintained this consistent level of ready access because I am a relatively "simple", "low maintenance" patient. - Time. Full labs and blood draws were done quarterly. Results were tracked and compared over time. Each draw was accompanied by a follow-up that could last as long as an hour, depending on how long you wanted it to (for whatever reasons). I never saw anyone look at a watch or a clock. Making informed decisions regarding diet, cholesterol, and lifestyle (for example) is much easier when your doctor can spend 30 minutes discussing your lipoprotein trends over the past five years against 30 years of varying data, trends in medicine, and studies of actual impact on mortality and quality of life. - Network and peer credibility. Their "med school buddies" were often in nationally recognized programs and specialties. Made an incredible difference in access at least once for me personally. Any referrals were met with similar levels of access, even in all-insurance or mixed practices. I've often said the single most important benefit of concierge medicine (for whatever underlying reasons) was that your physician actually LISTENS to you and treats you like a real person, a whole person. Not only does that make substantial differences in your perception of care (and overall experience) it made definite and substantial differences in outcomes in my experience.

arkades 10y ago

Concierge access is a business model largely dependent on the SES of the community the doctor is located in, and his personal charisma/following. It's very, very poorly correlated to physician quality. Access tends to be a lot better, but only in those practices that are 100% cash. Those practices that try to "transition" or do a mixed customer base tend to be the same as all-insurance practices, since they fail to transition operations/processes towards the cash-based context.

kkielhofner 10y ago
I should have mentioned that my experience is highly anecdotal - a handful of patients across a couple of doctors. Yes, these practices are 100% cash. I noted several key differences: - Top-tier education. Medical school and residency at top 5 programs in the United States. - Availability. They have total patient rosters in the low-hundreds, and many of these patients are seasonal. Response was always same day and more often than not immediate (phone, text, e-mail). I got the sense I maintained this consistent level of ready access because I am a relatively "simple", "low maintenance" patient. - Time. Full labs and blood draws were done quarterly. Results were tracked and compared over time. Each draw was accompanied by a follow-up that could last as long as an hour, depending on how long you wanted it to (for whatever reasons). I never saw anyone look at a watch or a clock. Making informed decisions regarding diet, cholesterol, and lifestyle (for example) is much easier when your doctor can spend 30 minutes discussing your lipoprotein trends over the past five years against 30 years of varying data, trends in medicine, and studies of actual impact on mortality and quality of life. - Network and peer credibility. Their "med school buddies" were often in nationally recognized programs and specialties. Made an incredible difference in access at least once for me personally. Any referrals were met with similar levels of access, even in all-insurance or mixed practices. I've often said the single most important benefit of concierge medicine (for whatever underlying reasons) was that your physician actually LISTENS to you and treats you like a real person, a whole person. Not only does that make substantial differences in your perception of care (and overall experience) it made definite and substantial differences in outcomes in my experience.