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Originally Posted by Yorio
...however recently, we were "forced" to join dues paying medical facility. It's called MDVIP based in Boca Raton. I am told that our doctor can not see so many patients, he is reducing patient load to 400 from 2000 plus. Have you heard about fee paying primary care physicians? This MDVIP is for profit organization since it is now owned by Proctor & Gamble. ...We feel like our doctors have been hijacked but guess from the doctors point of view, he can make just as much with reduced patient load. If you are in this or similar program, appreciate sharing your views.
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My wife and I have been patients/members/subscribers (whatever you want to call it) of a PRIVATE individual physician concierge, board-certified internal medicine doc since 2003, around the time this structure of healthcare delivery began to gain momentum.
I've studied concierge practices since then and NEVER read or heard about a case where a patient was "forced" to join one. It's impossible; would be like "forcing" someone to eat Big Macs instead of Whoppers. Can't happen. It's the free market at work in healthcare.
At the time we selected a concierge practice on our own free will, the advantages for us (we were around 60 years old at the time) were (1) immediate access to the doc when we needed to be seen, (2) virtually no waiting time at his office for appointments (as opposed to what we saw in The Villages with patients accepting many docs ignoring patients for 30 to 60 minutes past their appointment times before seeing them), (3) actual 24x7 access to the doc via his cell phone and email outside normal office hours, and (4) THOROUGH office visits without a 15-minute rush to get in, sign papers to verify billing info and get out, but rather to get a cure going on whatever medical problem existed.
For all those benefits, the monthly fee was well worth the cost; we could easily rationalize that annual cost as being an easy trade-off for, say, one less vacation a year, and/or several nice dinner nights a month not taken, a few less shopping trips wherever... whatever other discretionary spending we were making to trade.
There have been times when we were out of town, had a medical problem, called our doc and/or emailed him with photos of (in my case a few times) the damage I had done to myself in a fall or other self-imposed injury, and he emailed or phoned back with a long-distance remedy or had things ready for us as soon as we returned.
The relationship harkens back to the old days of the doc visiting you at home.
HOWEVER, the concierge practice was begun by individual docs with an entrepreneurial drive and business management skill who were tired of the increasingly aggravating and medically compromising bureaucratic procedures imposed by all the official meddlers in the relationship between the doc and his/her patients. It's the independence of the concierge doc's ability to make individual doc/patient decisions that characterized the most desirable aspects of the "concierge" practice for both the doc and patient.
Then the institutions finally awakened to this new paradigm in healthcare delivery, and they didn't really understand the fundamentals. The most important part of the fundamentals is the LACK OF A BUREAUCRACY, because the doc -- not an "insurance" company, not an HMO, not a PPO, not a Hospital, not an "alliance." not some third-party-administrator or other party -- made the medical decisions.
There is no more professionally managed company in the world economy than Procter & Gamble. (My first 50 years were spent in Cincinnati, their world HQ, and by osmosis everyone in Cincinnati with half a brain learns about and from P&G. With half a brain, I qualified.)
With consumer products in which P&FG dominates a market segment, their "sales presentation" to a retailer (usually big-box or nearly so) go something like this (I actually heard this presentation given to a Liberal Markets "buyer" years ago): "On (date), we will ship you (X) truckloads of product. On (next date), we will begin running TV and print ads in your market. On (next, next date), we will ship you another (Y) truckloads of product. (and so on)" Not quite the typical sales pitch of selling on features, function, quality, delivery and price and hoping it was attractive enough to best your competition and write an order. P&G ruled the market and generated the market demand with their consumer marketing that drew the product through the distribution chain.
Healthcare, I believe, if a different kind of sale; there are many conflicting interests the doc deals with, and the independent entrepreneurism of the docs has been key to the concierge practices succeeding up to this time.
As P&G has been doing, so has The Villages Healthcare Alliance in wanting to establish its own network of concierge docs. BUT, the two concierge system structures and objectives seem significantly different, with one significantly important common element. That common element is the huge bank of healthcare data which each bureaucracy will be able to access for its own objectives.
P&G wants to market a huge range of other healthcare,
pharma and perhaps even cosmetic-related products and services. P&G will accomplish that through its own use of all the patient, practice and outcome data it mines from all the docs who are a part of its program. As part of its "relationship" with the docs, P&G gets a portion of the monthly "membership" fee, and supposedly in return provides certain management and overhead services. My guess is those services will come with certain bureaucratic obligations on them to which the doc must abide in order to satisfy P&G.
The Villages wants to build a world-class healthcare center modeled on the reputation of Mayo Clinic, according to the letter the Developer sent to all Villages residents about a year ago. The healthcare data generated by the Central Florida Healthcare Alliance will be unique; there is probably no other community of close to 100,000 people of The Villages age and health demographics on which to build such a database. That information will have great value to many types of firms serving healthcare, and the Alliance will likely be the steward and purveyor of that data (with patient confidentiality protected according to HIPAA regulations.)
As to the concierge program, building the Central Florida Health Alliance through The Villages Hospital with Moffitt Cancer Center, the University of South Florida, and Leesburg Hospital, the presence of "bureaucracy" is far more than a singular noun, and how each party in that set of relationships with its own mission and vision puts pressures on the concierge docs hired by the Alliance or The Villages Hospital (whichever is the hiring employer) is bound to affect the doc/patient concierge relationship in ways that do not influence an individual doc-to-patient without such a bureaucracy relationship.
Long answer to your question, but your question raises many issues. If you seek out a concierge doc, there is a lot more than just the monthly fee to explore.
(EOM)