[Yorio]

Since spending more time in TV, got rid of country club membership north; 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'll have to pay $1650 a year PER PERSON. As far as I can judge, our doctor will not be doing anything more than what he has been doing previously as he is a very conscientious doctor. MDVIP says they'll do more but those things seem like frills. 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.

[Villages PL]

Originally Posted by Yorio

Since spending more time in TV, got rid of country club membership north; 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'll have to pay $1650 a year PER PERSON. As far as I can judge, our doctor will not be doing anything more than what he has been doing previously as he is a very conscientious doctor. MDVIP says they'll do more but those things seem like frills. 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.

I have heard and read about this type of medical care. It's generally known as "concierge medical service". But MDVIP is a good name for it too. Once you're in it you will be treated like a VIP. 400 patients is typical and that means you never have to make an appointment. You just walk in and the doctor will see you. Not only that but the doctor will not rush you; you'll get all the time you need. Having plenty of time helps as far as getting a correct diagnosis. Another good feature is that you will be allowed as many visits as you deem necessary. The yearly fee of $1650 is a little less than average.
Across the country, fees range from $50 per month to as much as $10,000 or $15,000 yearly.

I believe the new Villages Health Center(s) will be run this way too.

[Mudder]

Who forced you to join that practice? Can't believe anyone could force you to join something like that. If you are not of Medicare age it's probably a good deal, as that cost seems lower than average for that type of service. If Medicae age there are so many lower cost options.

[ilovetv]

Originally Posted by Yorio

Since spending more time in TV, got rid of country club membership north; 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'll have to pay $1650 a year PER PERSON. As far as I can judge, our doctor will not be doing anything more than what he has been doing previously as he is a very conscientious doctor. MDVIP says they'll do more but those things seem like frills. 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.

It's not really so much about "making just as much money with a reduced patient load" as it is about earning enough revenue to stay solvent and not have to close up shop completely. Medicare payments are already low and going downward (and insurance companies follow their "usual and customary" amounts)....while fixed operational, insurance and staffing costs remain the same and increase with inflation and uncollectible bills owed them.

[mokey]

The doctor we were with for 25 years started this in 2005 and they were charging $1200 per person at that time. We ended up changing doctors. We had been with the doctor since he had finished med school and started practicing and guess we feel like we were betrayed. More money, less hours is the name of the game.

[gomoho]

So do you just pay this annual fee for the privilege of being his patient - or does that include visits? Do you still have to pay for medicare and if so what does that do for you?

[gomoho]

Originally Posted by Villages PL

I have heard and read about this type of medical care. It's generally known as "concierge medical service". But MDVIP is a good name for it too. Once you're in it you will be treated like a VIP. 400 patients is typical and that means you never have to make an appointment. You just walk in and the doctor will see you. Not only that but the doctor will not rush you; you'll get all the time you need. Having plenty of time helps as far as getting a correct diagnosis. Another good feature is that you will be allowed as many visits as you deem necessary. The yearly fee of $1650 is a little less than average.
Across the country, fees range from $50 per month to as much as $10,000 or $15,000 yearly.

I believe the new Villages Health Center(s) will be run this way too.

My understanding is the new Village Health Centers will be paying doctors an annual salary and you stay with whatever insurance carrier you have. Doesn't cost the patient anymore to be part of their practice.

[Yorio]

I wish I could answer some of those questions but I am new at this. We were told that nothing will change until mid-September but there is a caveat that if total patients reach 400, you'll be put on a waiting list. We couldn't get how many have gone with the new arrangement when the presentation was made. I know that in addition to the monthly dues, we will be charged for services rendered but we don't know what that means. There is supposed to be a complete check up as preventive measures. Since many of us are concerned about.senility as we age, I asked whether MRI will be covered under this preventive care but the answer was no. I thought this will be preventive as dimentia may be checked in advance. If any case, Medicare will cover physical check-up once a year when Obamacare kicks in. So what is this extra. Also, i have veen happy with the time spent with the doctor and a little inconvenience of waiting or getting schedule, i thought i could live with. Guess from the posts, other corporations are doing this. What happens to those people who can't afford this cost. In my judgment it is a stiff cost but is this where medicine is headed?

[PTennismom0202]

Concierge practices are popping up everywhere, especially in big cities where there are wealthy, busy people. I just came from Washington, DC and worked in the health care industry. We consider this the beginning of a formalized two-tiered system based on the ability to pay. (There has always been a tiered system based on the ability to pay -- those who could not pay just went to the hospital ER or to Federally Qualified Health Clinics). None of my colleagues welcome this change. We have a lot of skewed access to advantages in America, and this is another one.

[ilovetv]

MDVIP is mentioned in this article....

"....The Wall Street Journal reports an expected shortfall of 60,000 physicians in 2015 and 90,000 by 2020 (roughly 10-15% of practicing physicians), even as millions of newly-insured patients enter the system. As a result, patients will endure longer waits for doctor appointments. Meanwhile because of declining reimbursements, primary care physicians are forced see as many patients as possible each day in hurried 10-15 minute appointments, simply to make ends meet.

In response to this frustrating situation, more doctors are seeking an alternative practice model. They are establishing “concierge” or “direct pay” practices, where patients pay a monthly or annual fee for enhanced services, including same day appointments, 24/7 access to their doctor, e-mail consultations, and longer appointment times.

Instead of the usual rushed 10-15 minute appointments, these doctors typically offer 45-60 minute visits allowing them to really delve into their patients’ problems and craft individualized treatment and prevention plans....."

Good care requires time, and with the overhead of a primary care practice running $200K/year per physician, time and reimbursement are at odds with each other…

Is Concierge Medicine The Correct Choice For You? - Forbes

[George Makrauer]

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.

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)

[PaPaLarry]

WOW!!!!!! Really have to give this serious thought, before signing on.

[billethkid]

as the country shakes out the real costs of the current health care deabacle, it will become more and more apparent to millions that....to continue with the level of care we have been accustomed....whether over 65 or not.....we will more and more be faced with increased fees of one kind or another.

Hence there will be a great disaprity between what the average American gets VS those who can afford more....and will complain but pay more.

The notion that the youth of America will monetarily support the health care needs of the elderly, the poor and not so fortunate is proving to not be a viable premise.

What we all have today is the best care at the lowest personal cost we will ever again see in our lifetime and these botique type care centers are proof of it.

[Hancle704]

$660,000.00 collected up front, plus Medicare and secondary/supplemental insurance later. What are his hours of availability? After the up front is there any additional charges. Will your doctor see you in hospital? If not, who pays the doctor that treats you in hospital.

[Bizdoc]

I had a student back in the mid 90s whose family had signed up with a concierge practice. I don't recall the exact amount per patient, but it was around 20-30K per person. The doctor made house calls when necessary and even had house keys (voluntary) in case of emergency.

Now most of the patients were executives at places like Microsoft and Boeing, so the cost was not an issue to them.

I have mixed feelings about this trend. As the gap in care widens, (great versus really bad), social tension is likely to increase.