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Concierge Medicine: Your Questions Answered

In the October 2012 issue, we investigated whether it was worth spending $1,500 or more a year on a physician who truly pays attention to you. Here, everything you need to know about what it would cost, what’s included and how to find a concierge doctor that’s right for you

by Cathryn Jakobson Ramin
woman doctor and patient image 

What will it cost me?

·         The retainers that concierge docs charge annually range from about $1100 to $2100, although some doctors in mega-bucks neighborhoods charge much more.

·         Note that there are also direct-pay docs who accept fees on a month-to-month basis, but they do not provide all of the amenities described in the next column.

What is usually included?

·         The annual comprehensive wellness physical, including a blood panel and in some practices, multiple screenings and tests.

·         24/7 access to physician by cell phone, email and text.

·         Same-day office visits, with little or no waiting

·         Care from your own physician if you get sick when you’re out of town.

·         Plenty of time to talk over routine concerns during office visits

·         Easily accessed and meticulously maintained electronic medical records, sometimes available to you on line, always ready to be sent to specialists or the ER.

·         Facilitated referrals to specialists, meaning that your doctor will contact other doctors for you, arrange your appointments, discuss your case in detail with the specialist, and follow up with you about your visit to the specialist.

·         Assistance you’re your physician in obtaining pre-authorization and pinpointing the best specialist in network with your health care provider.

·         Focus on preventive medicine, rather than reactive medicine

·         In some practices, but definitely not all, a concierge doc will also care for your post-pediatrician-age child, up to age 26, included in your retainer fee.

·         Some docs offer online services such as medical information, prescription refills, secure online e-mail with one’s personal physician, online lab results and access to digital x-ray reports and images

What is not included in the concierge retainer?

·         The co-payment for office visits, except for the annual comprehensive physical.  (Usually, your co-payment is listed on the plastic insurance card you keep in your wallet. My co-payment, for instance, for my individual Anthem PPO Saver plan is $30 per office visit.)

·         Lab tests, scans and screenings conducted in facilities outside the concierge practice.

·         Appointments with specialists

·         Procedures, surgery and hospitalization, including visits to the emergency room.

How can signing on with concierge doctor save me money?

·         You may be able to switch to a high-deductible health insurance policy, thus reducing your monthly payments. (See: “What kind of health insurance plans work with concierge medicine?,” below, for more on this.)

One of our patients shared this nice write-up from More magazine covering the basics of private/concierge medicine. It’s a quick read in a Q & A format and covers many of the common questions about this practice model. Of course there’s no substitute for the real thing–set up a time to come in and meet us in person to see if we’re a good fit for your healthcare needs!

Vitamin E & Prostate Cancer

Another study showing that just because something has the word “vitamin” in it, doesn’t mean that it is good for you.  Last month’s report on the SELECT trial, which looked at over 35,000 men, found that men taking vitamin E supplementation had a 17% increased risk for prostate cancer.  The original study was actually stopped early because of the increased cancer risk, and now they’ve found that the increased risk has persisted despite the study and supplementation being stopped 3 years ago.  Vitamin E is often included in multivitamins and is often praised as an antioxidant, but it seems that it fails to deliver in some important health conditions.  Because some vitamins and supplements can be beneficial, and others appear to be harmful, I encourage you to talk with your physician about them.  To help facilitate that conversation, bring in the bottles of the supplements you are taking.