Doctors Charging "Membership" Fees

[Cruise]

I'm sorry if it sounds like I am bashing doctors in this thread, I do not mean to come off that way. I also understand that a doctor's office is a business and needs to be profitable. It is just that it makes me sick the way this country is going where we care more about the money in our pockets than about human life. I'm not sure what the answer is, but IMHO elite doctors, outrageous health care premiums, escalating health care costs, and only treating people that can afford it is definitely not the answer!

It's not only doctors caring about money in their pocket. The cost of malpractice insurance and the risk of lawsuits is so great now that many people who many have once considered a career in medicine go different routes now.

And I can't even imagine the hoops that doctors have to jump through to receive payment from insurance companies or Medicaid.

 

[dodukes]

I used to go to an OB/GYN who charged a $5 "comfort fee" (on top of your usual co-pay) if you wanted a paper sheet to cover yourself during the exam. Now, who is NOT going to pay that?

I have read up to here and wanted to respond, if my doctor would give me a $5 discount for that "confort sheet" I would gladly take it. Seriosuly he's already perusing up there, who cares if he sees it before while talking... heck id forgo the whole outfit if I coudl save a rfew bucks.

 

[fkj2]

It's not only doctors caring about money in their pocket. The cost of malpractice insurance and the risk of lawsuits is so great now that many people who many have once considered a career in medicine go different routes now.

And I can't even imagine the hoops that doctors have to jump through to receive payment from insurance companies or Medicaid.

Yes, it's that, but perhaps more so, it's our society at large. For many years as the generational sizes grew, we could absorb additional needs/wants by the less fortunate of our society. But the age curve has reversed, and we see more and more people at the upper end of the age curve needing/wanting more than the younger and smaller generations can financially afford, as technology advances (increasing costs) and demand rises, coupled with the economic realities of competing in a global environment.

Physicians--and ALL medical specialities as nearly as I can see--DO make accommodations, but it's reaching a breaking point and I think that's what the population at large can't or won't acknowledge because it's not a scenario that is familiar to us.

I keep wondering what companies--aside from individual contributions--are donating all the food that food banks give out--and are running out of. No one demands THEY donate a percentage of food they package. No one demands that utilities donate a percentage of power. No one demands that oil companies donate gasoline. All are necessary to our lives. I don't have an answer but I think it's important for us as a people to stop leading such independent lives and learn to rely more on each other.

 

[15isto2]

Not only that, but if you walk into an ER, you're seeing someone who's never seen you before and has no idea about your medical history other than what you tell him/her. Some people are on so many medications today that they can't even remember them all. There may be small nuances to your past medical history that your PCP can add to the situation.

Why go the the ER if its something you want your PCP to deal with?

 

[fkj2]

Why go the the ER if its something you want your PCP to deal with?

Well, as an example, if someone's having urgent symptoms of chest pain, they're likely to go to an ER rather than wait until the PCP's office reopens. Not only that, but the hospital has diagnostics than an office wouldn't

 

[Shelli_5]

I also understand that a doctor's office is a business and needs to be profitable. It is just that it makes me sick the way this country is going where we care more about the money in our pockets than about human life. I'm not sure what the answer is, but IMHO elite doctors, outrageous health care premiums, escalating health care costs, and only treating people that can afford it is definitely not the answer!

I agree 100%.

 

[Cruise]

Why go the the ER if its something you want your PCP to deal with?

As fkj2 pointed out, sometimes it is the only option due to the time of day or urgency of the problem.

Personally, I've only ever been to the ER once in my lifetime and that was arriving by ambulance.

I also took my DH once when he cut his thumb badly at 9pm and required 10 stitches. But, even then, it was after we had called an urgent care phone number to see if it was something that could wait. We were told it couldn't.

 

[fkj2]

The public needs to be asking some hard questions about the healthcare our elected officials receive. You don't hear much about that, huh? They have access to the best and brightest...and we pay for that privilege. There's just something wrong with that picture.

When I think about how we could have saved some $$ by insisting that the Medicare negotiate lower prices with Big Pharma but didn't...it's frustrating. And then we wonder where the money goes.

 

[karice2]

What I'm saying is that since Medicare/Medicaid is a government run program and the government issues the licenses to the doctors, the doctors should not have the right to refuse to take it. This does not mean that they should have to take every Medicare/Medicaid patient, but they should be required to take some.

Using that logic, hair stylist, nail technicians and social workers are all licensed by the government so they should be required to provide a certain amount of service to people. Just because someone has to have a license to perform their job does not mean they should be required to do anything outside of their normal licensing requirement.

Forcing someone to do that is tantamount to indentured servitude or serfdom. I will allow you to do work that benefits you but a certain amount of your work must benefit me.

 

[EKW]

Well, I haven't read all the details, but it sounded like the fee is on top of the co-pay. They are pushing it as being that you'll have better access to your doctor because they will have less patients to see. Still, I have a problem having to pay whether I go or not. Now, if there was an added fee (say $25-$50) everytime I see the Dr, I probably wouldn't have a problem with it, but $25-$45 dollars a month for each patient seems a bit steep to me.

I'd send the doctor a copy of the Hippocratic Oath, especially this part:

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

and a note saying that his little confidence scheme won't work with me...that I wish him the best with his marks, er, remaining patients. Oh, and maybe a copy of the song "There is a Sucker Born Every Minute" from Barnum.

I'd also probably write an open letter to the local newspaper expressing my disgust with his tactics and concern that this may become a trend.

I wouldn't stay with him even if he offered to let me stay for free. He is arrogant, greedy, and the concept of ethics seems to illude him!

 

[Cruise]

I'd send the doctor a copy of the Hippocratic Oath, especially this part:

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

and a note saying that his little confidence scheme won't work with me...that I wish him the best with his marks, er, remaining patients. Oh, and maybe a copy of the song "There is a Sucker Born Every Minute" from Barnum.

I'd also probably write an open letter to the local newspaper expressing my disgust with his tactics and concern that this may become a trend.

I wouldn't stay with him even if he offered to let me stay for free. He is arrogant, greedy, and the concept of ethics seems to illude him!

So you're saying the doctor has to consider his/her patients " family and economic stability" but not their own? Would it be acceptable instead to require all patients to volunteer 5 days a year at the office? By the way, the patients would all have to get some kind of medical training to do so... but they'll have to pay for that on their own so they can do the volunteer work. But hey, it means the doctor will have less overhead costs, so it should all work out, right?

 

[dvcgirl]

I'd send the doctor a copy of the Hippocratic Oath, especially this part:

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

and a note saying that his little confidence scheme won't work with me...that I wish him the best with his marks, er, remaining patients. Oh, and maybe a copy of the song "There is a Sucker Born Every Minute" from Barnum.

I'd also probably write an open letter to the local newspaper expressing my disgust with his tactics and concern that this may become a trend.

I wouldn't stay with him even if he offered to let me stay for free. He is arrogant, greedy, and the concept of ethics seems to illude him!

I don't agree with this at all. Physicians are also small business owners in many instances, and it has to be about survival and yes, success. Do you know that the average General Practitioner earns roughly 160K a year. How many of you would go through 8 years of school and several years of residency before peaking out at 160K a year? And that's if they're lucky. Oh, and that number is forecasted to go *down* as medicare reimbursement continues to fall.

Sending an open letter to a newspaper because a doctor is charging for patients to get into their practice so that they receive excellent service? Doesn't sound like a huge scoop to me.....

 

[clarabelle]

Definition (roughly) of concierge medicine

http://en.wikipedia.org/wiki/Concierge_medicine

 

[ssawka]

Sending an open letter to a newspaper because a doctor is charging for patients to get into their practice so that they receive excellent service? Doesn't sound like a huge scoop to me.....

Actually, the local TV station did do a report on it. Didn't really say much about it, so their report was pretty useless other than to let people know it was going on.

 

[ssawka]

The one thing that hasn't been mentioned in this thread is that depending on the insurance plan, PCPs are already paid a retainer. It's called a capitation rate. Now I have no idea how much that is or if insurance companies have scaled those back. I also don't know how it's calculated since many HMOs are not requiring you to name a PCP anymore.

 

[kaytieeldr]

I sure wish things could change. Our favorite pediatrician practiced medicine for over 80 years.

Um, is that a typo, or did this doctor really practice into her hundreds?

That amount of money doesn't even pay overhead/malpractice for a year-even for a small office!!!!

Well, a couple of things. First, we're not talking about any size practice, we're talking about individual physicians (back somewhere in this thread, at least one poster pointed out that one of the three doctors where they go went this route, not the whole practice) - so the charge appears to be per physician, not per practice. After all, if you're paying for a concierge doctor, you expect THAT doctor, not just someone in the practice.

So then I did a little research. Now, granted, I'm fully aware that these rates are outdated and it's entirely possible there've been astronomical increases in the last three years, but effective 2008: in not one location (DC included) could I find anywhere that malpractice insurance for an individual internist was over $100,000. In only a handful of states did surgeons and OB/GYNs not have at least one under-$100,000 option. And it appears that from 2007-2008, insurance rates decreased.
http://mymedicalmalpracticeinsurance.com/medical-malpractice-insurance-rates.php

Again, I'm well aware those figures aren't up-to-date. I started researching after I got home really early this morning and didn't care to delve too deeply.

 

[fkj2]

The one thing that hasn't been mentioned in this thread is that depending on the insurance plan, PCPs are already paid a retainer. It's called a capitation rate. Now I have no idea how much that is or if insurance companies have scaled those back. I also don't know how it's calculated since many HMOs are not requiring you to name a PCP anymore.

Not all patients are enrolled in manage care programs. The important thing to remember is the payment is the same whether patients require a lot of care or a little. The natural tendency is to accept only the healthiest patients because the profit margins will be greater and refuse the others.

 

[GoofyGolferGirl]

I can see why a doctor would want to do this, they have families too and I am sure they are able to spend more time with their families if they have a set amount of money already coming in.
From a business stand point it would be great imho. They can actually practice medicine by getting to know their patients. One person said their child was sick and the doctor came to their house seen the child and wrote a prescription. Think how much this saved the patients insurance company they did not have to pay for a visit to the ER!
Personally I think I would pay for the service, especially if I liked the doctor. I think we are going to see a lot more of this in the future, and unfortunately those on medicare and medicaid will be the ones to be affected the most. In our area more and more doctors are not taking medicare medicaid patients because it simply is not profitable, and more and more doctors are leaving to go to larger towns/cities where their are more people to treat that are not on medicare/medicaid. I live in Ky and KY just hired a company to investigate fraud with the medicare /medicaid system, they except to save our state around 27 million a year, if every state saved this much think of the benefits. From what I understand this is just for billing errors etc., imagine the saving if they also targeted the people who are abusing the system.

 

[arminnie]

I would give anything to find a good conscierge doctor. I even used mine in CA for 3 years after moving away.

I am now on Medicare. I live in a city with only 180,000 pop. plus we have a major medical school. Shouldn't be hard to find a doctor? HA!

Virtually all the doctors will severely limit the number of Medicare patients they see. I have a great doctor, but once I became eligible for Medicare it takes me at least 2 months to get a 10 minute appointment. I am only allowed to discuss 3 items. Sure tell me to get another doctor - You can't believe how many just say "no" when Medicare comes up.

I've made SEVEN trips to the ER this year which is absurd. I have Medicare plus a great policy from my employer - but because Medicare is primary it doesn't matter that I have a good secondary policy.

I hate the idea of using the ER for my primary medical care - but I can't wait two months when I have a staph infection that quadrupled the size of my hand.

 

[torinsmom]

Hey, maybe I could become a concierge teacher? I would give the parents who paid the membership my cell phone number and personal email and spend more time teaching their child above and beyond what the "normal" students would get. Instead of them having to come to school for a conference, I would come to their house and meet with them twice a year, and there would not be a 15 minute limit on the conference. They would get priority placement in the class of their choice for the next year as well. If I charged $25/month for that service, and half the students were "members", maybe I could do without the second job I have to work to make ends meet on a North Carolina teacher's salary.

Seriously, anyone looking into a career should do research about that career. Yes, doctors have more loans to pay back, but they also make more money than someone like a teacher. And FWIW, I work for two residents and they make a decent salary as residents. So, yes, they are in school twice as long as a teacher, and they have 2x the loans, but even a doctor making $150,000 is making 3-4x as much as many people in a year.