Healthcare options have become more complicated and less easy to understand over the last several decades. Insurance companies have become the main method for paying for what we need, with the amounts consumers pay out of pocket growing at a staggering speed.
It is hard to imagine that there is any other way.
When doctors decided to become primary physicians in the days before health insurance, they would set up an office and charge a modest office visit fee to cover the services they provided.
Some patients would be billed every month, some not. Either way, the expense was fairly low and manageable. There was no “out of pocket”, or “co-pay”, or “maximum benefit”.
( I should interrupt myself here to mention that, for the purposes of this article, we are only discussing outpatient physician care and not hospital based treatment for surgery or illness. That is a completely different conversation and I will take it on, just not today.)
Anyway, these days, insurance companies typically tell us who they will pay for us to see and those doctors and providers better keep their paperwork up to date or else. It isn’t the most user friendly of systems and it really feels like, as a patient, we don’t get to make many choices for ourselves. Does it seem like you have healthcare options?
What’s My Point?
You and I can change that. We can change it and still receive the healthcare we need.
There is a small, but growing type of primary healthcare in the U.S. that is providing services the way they used to be offered. Office visits at a reasonable price without the layers of bureaucracy and cost that now infect the system. Memberships, if you will, that give a consumer access to his or her provider in a way that has not been seen for decades.
Are you confused? Don’t be. I have taken the liberty of gathering information from one such doctor so that it is clearer and easier to understand.
We have been so conditioned to think that insurance companies are the authority on our health that it is like exercising rarely used muscles when we consider that there is another way.
In His Own Words
Dr. Paul Kartchner (http://www.familydoctor.md/) is one of the doctors who has set up a membership/concierge practice in the Tucson area.
With his permission, and in his words, this is how it works:
“I work for my patients, not for insurance companies.
I don’t accept health insurance. Patients join my practice by paying a monthly membership fee, similar to what you might pay for a gym membership or a cell phone plan. In return, you get 24/7 access to me via my personal cell phone as well as appointments scheduled within 48 business hours from the time you call. I even provide house calls, if necessary. Certain additional services, such as labs, medications and procedures, are provided at wholesale prices. It’s that simple. There are no hidden fees and no surprises. What’s more, I get paid for giving excellent care and for being available. If I can keep you out of the clinic or out of the hospital, we both win.
Consider that the average primary care clinic in the US has around 2000 patients per doctor, about a two-week wait to get an appointment, and you spend ten minutes or less with your doctor when you do get seen.
In contrast, I limit my practice to around 500 members. As a result, my patients can get seen when they want and can spend as much time as they need.
This plan includes unlimited office visits, same/next day scheduling*, extended appointments, an annual flu shot, free or discounted labs, access to a secure patient portal, your physician’s personal cell phone, and house calls within our service area.”
Something To Think About
Whoa. That kind of plan sounds just simple enough to work! It is certainly the kind of primary practice medicine that a lot of doctors went to medical school to learn. For those of you (yes I see you out there) who are shaking their heads and saying, yes but what about the hospital and what about the ER and what about (fill in the blank here)?
Those costs exist. They exist outside the office of your doctor. HOWEVER, consider that with increased access to your provider, many problems that end up in hospital stays can be treated before they become severe. Saw the doctor yesterday, but you just feel like you have more questions? Call him. That’s right. ON HIS PHONE THAT HE ANSWERS. Need a follow up visit but it’s been only a couple days? You are one of less than 500 patients, the doctor will see you now. (For more detailed information on the services Dr. Kartchner provides, see his website here (http://www.familydoctor.md/)
There are new challenges in health care today. Let’s meet those challenges with some answers of our own.