1 In 10 Independent Doctors Converting To Concierge Medicine
A confluence of factors – including the implementation of the Affordable Care Act and diminishing Medicare payments – are prompting doctors in private practice to embrace concierge or retainer-based medicine.
In fact, new data from a national survey of nearly 14,000 physicians conducted by physician staffing firm Merritt Hawkins for The Physicians Foundation, analyzing 2012 practice patterns, found that 9.6 percent of “practice owners” were planning to convert to concierge practices in the next one to three years.
The movement exists across all medical disciplines with 6.8 percent of all physicians planning to stop taking insurance in favor of concierge-style medicine or so-called “direct primary care.”
“Physicians have been running for cover for several years now. There is a lot of uncertainty in health care now and the only certainty is there is a lot of talk about cutting physicians fees. One way to get out of it is to go off the grid,” said Mark Smith, president of Merritt Hawkins in a recent Forbes magazine article.
Already, one in five physicians is restricting the number of Medicare patients in their practice and one in three primary care doctors – the providers on the front lines of keeping the cost of seniors’ care low – are restricting Medicare patients, according to a 2010 AMA survey of more than 9,000 physicians who care for Medicare patients.
“It’s not just for the rich and famous anymore,” Merritt Hawkins’ Smith said of concierge medicine and direct primary care practices. “If you can afford a gym membership, you can afford this kind of care.”
The survey also found that more than 50 percent of physicians plan to cut back on patients, work part-time, switch to concierge medicine, retire or take other steps that would reduce patient access to their services.
“We are in the process of ruining the profession. Medicine is not a shift work job – it is a profession (even a calling, for some) of great importance to all of society,” commented one doctor in the survey. “It is very discouraging that the best are being kept from learning and/or doing their best because of ill-conceived outside intervention (of many different sorts); the current situation is very, very sad.”
Still another doctor in the survey bemoaned how government and the insurance industry had become more dominant as patient/physician relationship deteriorated. “As further intrusion into the patient/physician relationship occurs it will become much worse. Almost all physicians I know abhor the present system. It pits physician against patient all because of money,” he said.
Many doctors are finding that the alternative to just calling it quits as a private practice physician in the 21st century is to embrace a new business model that, ironically, harks back to the not-too-distant past.
“No matter what you call it, direct primary care, retainer-based, concierge medicine, personalized care, it all translates into a type of medicine that just a generation or two ago was the norm,” says Matt Jacobson, CEO-founder of SignatureMD, a leading provider of concierge medicine to physicians and patients. “In this sense, concierge medicine is a back-to-the future business model where medical services were paid in cash and where doctors practiced preventive medicine.”
What is concierge medicine? For a regular monthly fee, patients receive a suite of “patient-friendly” services simply not available with conventional medicine, including 24/7 cell phone or email access to their doctors, no-wait and same-day appointments, extended doctor visits – even house calls.
Even more, because concierge medicine doctors can afford to limit their patient loads, they have the time to practice proactive care with their patient, which is focused on preventing chronic diseases rather than just treating their symptoms.
“Chronic diseases contribute to 70% of the healthcare costs in this country, and the obesity epidemic will continue to fuel this escalating problem. It is the elephant in the room that everyone is trying to ignore. Why??” asked another exasperated doctor who responded to the survey.
The trend of doctors embracing concierge medicine comes at a time when the nation is facing a severe doctor shortage – some 65,000 by 2015, according to the Association of American Medical Colleges. By 2025, the shortage is projected to grow by between 140,000 and 214,000 physicians. Starting in 2011, some 75 million Baby Boomers began turning 65, becoming eligible for Medicare at a rate of one every eight seconds. Physicians will soon be expected to treat millions of additional Medicare patients, many of whom will require comparatively more physician time than younger patients. Then there’s the Affordable Care Act, which will add 32 million previously uninsured Americans to the health care system, beginning in 2014.
The doctor shortage is particularly acute among primary care physicians (family doctors, internists, GPs and pediatricians). The problem is exacerbated by med school students increasingly eschewing primary care as a career option in favor of specialties. (An orthopedic surgeon earns three to four times more on average than a primary care doctor).
“Primary-care providers work hardest, have the most unrealistic expectations placed on them, are paid a fraction of what specialists earn… and diminishing numbers of graduates are choosing primary care,” noted a physician in the survey.
Concierge medicine provides an incentive for both seasoned primary doctors to stay in the profession and for med school students to seriously consider it as a career pathway. “The family doctor in private practice is an endangered species because of all the various market forces at work that have steadily eroded their income over the last two decades. Retainer-based or concierge medicine offers an appealing alternative to both patient and physician to what has become institutionalized health care in this country,” says SignatureMD’s Jacobson.
SignatureMD (signaturemd.com), with offices in Los Angeles, California and Richmond, Virginia, is one of the nation’s largest providers of initial conversion and ongoing support services to concierge medicine physicians, with an expanding network of over 160 affiliated primary care physicians and specialists across 31 states.