CONCIERGE MEDICINE – IS IT RIGHT FOR YOU?

CONCIERGE MEDICINE EDUCATING THE PUBLIC GETTY IMAGES

CONCIERGE MEDICINE
EDUCATING THE PUBLIC
GETTY IMAGES

Medical 2015
by – Sheri de Grom

The emerging model of concierge medicine has its roots in both patient and physician frustration.

BASIC CONCIERGE MODEL

  • Patients pay a monthly or yearly subscription fee to join a physician practice.
  • The physician controls the number of patients in his practice and his income.
  • The patients get 24/7 access to their doctor via phone and email, same-day appointments that can last hours, and a relationship in which the doctor’s and the patient’s interests are closely aligned.
  • Concierge medicine is a growing premise of provider care. A company, MDVIP is the largest concierge medicine consulting company in the nation with more than 700 physician members and more than 200,000 patients in 42 states.
  • MDVIP is a hybrid model that provides a comprehensive wellness screening of all patients. This patient screening becomes the foundation of the doctor-patient relationship. MDVIP accepts insurance, including Medicare, and 94% of patients renew with affiliated physicians.
  • A physician with MDVIP sees between 10-12 patients a day. He has a patient panel of about 400 patients, about 10% of his former patient load. He receives about $140 a month per patient and he cares for the children of patients at no charge. MDVIP takes care of all insurance billing and reimbursement.
  • Another example includes physicians who charge by age group. Sliding scales often range from a yearly fee of $750 to $4,500. Some doctors screen patients and others don’t.
  • A concierge physician has the freedom to include as many services in his practice as he wishes. He controls every aspect of his business. He may or may not have a traditional office.
  • At the extreme you might find a doctor with a vehicle equipped with advanced testing equipment and he sees all patients on house calls.
  • Another physician might make arrangements for their patients to receive lab and imaging tests for about 10% of the cost that providers bill insurance companies.

Concierge physicians receive guidance as members of the American Academy of Private Physicians (AAPP), a nonprofit group which works with its members to build sustainable concierge medicine practices.

According to the American Medical Association there are approximately 246,000 primary care physicians practicing in the U.S. Approximately 40% are employed by health systems and hospitals. That leaves about 148,000 primary care doctors in private practice.

The editor of Concierge Today reports there are 5,500 doctors practicing concierge medicine and that rate is expected to grow by 15% a year.

The American Academy of Family Physicians kept concierge medicine at arm’s length for years, but is moving quickly to embrace the direct care concept.

A recent study by the Annals of Family Medicine projects there will be a shortage of more than 50,000 primary care doctors by 2025.

John Rother, a policy expert at the American Association of Retired Persons (AARP) wrote, “Those who can afford to pay a monthly fee will get better health care than those who cannot. Medicare patients, who universally have lower incomes, are at a disadvantage under such an evolving two-tiered system.”

After battling our current health care system for Tom’s life over the past 8 months, we would have concierge care, if I could afford additional capital outlay. An internist in a nearby city has joined a concierge team and I hope to interview him in the new two months about taking Tom on as a patient. My frustration is born of not having quick access to Tom’s internist. I’ll be the first to agree that Tom’s body is medically complex but I believe if I could achieve intervention by a physician that cared about his physical health, we could prevent much of what turns into life and death situations. [A perfect example of this is the inability of getting a timely appointment and a virus turning deadly causing last week’s emergency of cardiac arrest].

Or, is the above another example of medicine turning its’ back on the mentally ill patient and physicians continuing beliefs that a patient couldn’t be as ill as reported when requesting an urgent appointment?

My own internist has a highly-qualified Physician’s Assistant on his staff and I have 24/7 access to medical care. I know that when I call my internist’s office, I may not get to see him within 2 days but I will get to see his PA and if my situation is something she needs to consult my doctor about, she does. This has worked for me.

Tom and I used to share this internist and we should have had the same relationship with him but the internist couldn’t get past the idea of Tom’s bipolar diagnosis and thus, was not a good fit for Tom.

I’m all for everyone finding the best medical care for themselves. For the past 8 months with additional medical complexities occurring with Tom, we needed a doctor willing to take calls and guide us through the medical maze that stood in our way. Instead, Tom might have lost both legs and worse, died of an unidentified infection.

It’s hard for some Americans to wrap their heads around the concierge medicine model. Under the law, every American is required to have medical insurance – but direct primary-care patients can seek less expensive policies, because they require coverage only for hospitalizations, surgeries and other specialized care.

Concierge medicine provides a direction to primary care and a less expensive insurance policy than those currently offered by Obamacare. This new approach covers all preventive services and insurance would only be required for hospitalizations, surgeries and other specialized care.

In my opinion, there’s much to be said in favor of concierge medicine.  I wish it had come along 20 or 30 years ago.

When people get good primary care, their maladies are diagnosed more quickly and can be managed before they grow into crises. Fewer patients wind up in expensive hospital beds. Emergency rooms treat genuine emergencies, not routine infections and minor injuries. Patients receive timely advice and encouragement from a trusted physician to shed those pounds, change that diet, drink a little less and exercise more. Insurance models discourage this holistic approach. Insurance pays for treating diseases, not addressing questions about preventative care.

It’s no wonder Primary Care Physicians prefer to cut their own path in their own medical practices. The Medicare Formula guiding payments to doctors will cut payments to all physicians by 21% on April 1, unless Congress overrules it. Primary care physicians are also facing a scheduled Medicare cut of 10% on January 1, 2016, unless Congress overrules it, which would be in addition to the cut all doctors will take on April 1, 2015.

Is it any wonder primary care physicians are leaving traditional medicine when in today’s

Getty Images

Getty Images

concierge medicine the average take-home payment is $200,000 to $250,000 per year and they don’t have to worry about Medicare or any other reimbursement policy change. Neither do they have to do mountains of paperwork. These groups of Primary Care Physicians treat their patients, the very reason they went to medical school in the first place.

How about you, have you had experience with concierge medicine and if so, would you like to share?

Would you consider giving concierge medicine a try?

Medical care is changing. Can we afford to allow congress to dictate our healthcare needs? We must have give and take. What risks must we be willing to take?

For Tom and I, perhaps our ideal would include a Concierge Physician for at least Tom and we would continue to maintain the insurance coverage we have. My sole reason for the concierge — immediate access. We have insurance that provides coverage for the specialist in place as well as pharmacy and hospitalizations. I see the Concierge Physician as the doctor that just might be the one that could keep Tom alive!

Today, it’s not just a Medicare issue. Primary Care is everyone’s business.

Thank you for reading with me and as always, I look forward to hearing your thoughts on this all important subject.

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About Sheri de Grom

Retired Fed/JAG, 5 yrs. on Capitol Hill. Former book buyer for B and N. Concerned citizen of military drawdown. Currently involved in mental healthcare reform, health care strategist and actively pursuing legislative change wherein dual retirees are exempt from enrolling in Medicare at their own discretion without losing tertiary healthcare benefits. Monitor and comment on Federal Register proposed legislation involving Mental Health, Veterans Affairs, Health and Human Services, Medicare and rural libraries. Licensed OSHA Inspector to include Super Fund sites. Full time caregive to Vietnam era veteran. Conceptualized, investigated possible alternatives, authored, lobbied for, and successfully implemented Title X, Section 1095 (known as the Third Party Collection Program of Federal Insurance).
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74 Responses to CONCIERGE MEDICINE – IS IT RIGHT FOR YOU?

  1. inesephoto says:

    Sheri – I am trying to catch up. Don’t want to miss any of your posts – many of them are like a revelation to me. For example, I have no idea that the concierge medicine ever existed. I like the concept. People have to have some choice.
    Inese

  2. 50djohnson says:

    I turn 65 in July and I’mbeing bombarded by the world by mail.!! Thank you so much for the follow. Looking forward to getting to know you better.
    Blessings,Debbie

  3. This was very informative. I had no idea that Concierge Medicine existed. I am not sure how I feel about this. The family doctor we have, is almost always available to us. However, we drive over an hour away to see him. If we were to go to a doctor in our town, it would be a few months wait. I guess it depends on the individual person and the needs that they have. Sounds like it’s exactly the kind of care that you need.

  4. Sheri I just want to share again with you, what I said in in my final response to your comment on my Post… and that is you have wonderful informative Posts on Medical care that people need to know about, not always applicable to me because of living in Australia but I have gained knowledge of what I didn’t know too, we all have our gifting and I thank God for yours.

    Christian Love Always – Anne

  5. HI HI HI! I saw you pop in and I had to come over here to read this! I don’t know where to start…so I’ll just share that my Alex has finally finally been diagnosed with bi-polar disorder. She was diagnosed at the age of 14 with depression. It was hard to diagnose I think because she’s been sick all her life as we’ve talked but in this case, well for lack of a better term it’s like she’s lose a grip on reality! She tried to wean herself off her meds at the age of 20 now 21 she’s really in trouble again and thankfully we found a doctor that was willing to take on her case because of all the underlying chronic illnesses. I love how detailed this post is. You spend so much time researching and sharing I wanted to tell you that I appreciate you! I’ve been so busy with Alex and focusing on her I haven’t been over to say hi and I know you have your hands full! We should have a latte’ and rest I think! It’s so important! I remember your saying this to me! I think of that often! Huge hugs and I’m thankful for us both that Spring is here and dirt therapy can begin! Gloves on! ❤ 😀

    • I almost wrote a message last night before my eyes gave out to let you know how much hope and inspiration I take away from your blogs. They lift me up and I dwell in a place of peace and serenity when I’m reading with you.
      I’m so sorry to hear about Alex’s new diagnosis. I will be returning to more bipolar blogs in the near future. I wish I had known 25 years ago what I know now. I firmly believe the major reason Tom’s body is falling apart at such a rapid pace is from all the psychiatric medications he’s taken over the years.
      If you don’t mind letting me know what type of insurance Alexie is on, I’ll be happy to research their benefit clauses for you. You can send the name of the company to my e-mail if you like.

      • She is on Blue Cross and Blue Shield of Illinois! I know what you mean! It’s so scary all she has taken so many years. When she gets pneumonia only the high powered kind work! The side affects sometimes are worse I think with a lot of meds!
        Thank you for your precious comments. I love that you know so much! I was to share that her new doctor’s middle name is Sparkhle Isn’t that interesting! I love that!
        If you feel to email feel free to! Bless you sweet friend! I believe it’s time for a latte’ ❤

  6. cindy knoke says:

    Very interesting and thought provoking post Sheri. You definitely captured my interest.
    My husband and I were just discussing this as my doc, not university affiliated like my hubby’s, tried to sell me a concierge plan. My husband is a biostatistician prof and medical researcher and many of our friends are university affiliated physicions.
    I see my doc once a year for my annual wellness rip off exam which consists of taking my blood pressure and rewriting my thyroid script, so this is not of interest to me. Morever I found it pretty terrible that he is selling better care and attenton to those patients who pay him for it. He has two classes of patients now, those who pay and get more attention and care, and those that don’t pay and get lesser attention, time and care. Only an American for profit health system, where decisions are routinely influenced by the bottom dollar, could come up with a plan like this.
    I have less of a problem with docs who exclusively provide conciege care, although I would never see them as a patient because I think they lack ethics. but I do have a problem with two tiered health provision by the same doc offerring better care to those who pay.
    Of course this is what’s wrong with our Mental Health system as well. Profit influencing who gets quality mental health care makes for fractured service delivery. This is why for 30 years as a therapist I worked for a salary and never charged my clients for care. Money never entered my decision making process. Since we pay for physicians medical school tuitions, I would expect and hope for the same from them. Many of the best and brilliant physicians are salary based and provide care based on need, not profit.
    Thanks again for an interesting post Sheri and I hope it is okay for us to agree to disagree! Hugs & friendship~

    • Cindy – We are actually on the same page. . .perhaps on separate lines. The only reason I would consider an internist via concierge medicine for Tom is that when I need medical care for him, I need it immediately and not one day 3 weeks away. However, with our last medical crisis on March 23 [Tom went into cardiac arrest] I now have the attention of his internist and an almost immediate response time.
      I’ve had a long up-hill battle and coping with Tom in severe pain and in a wheel chair for a lengthy period of time plus an incorrect diagnosis for 8 months has had my head spinning. It’s no wonder people don’t know what to do about health care – most of the time it’s not there unless you keep fighting. I never thought medical care would be harder to obtain than mental health care, but it is if the patient has a mental health diagnosis!

  7. I found your summery Sheri interesting and comprehensive, I will give it further thought.
    .
    I go to a Surgery now that Bulk Bills everyone, they have 9 doctors on different shifts, which are available from 8am till 10pm, 7 days a week including Public Holidays, they also have visiting Doctors for after hours. There are no appointments which means sometimes there are long waits but you can choose your Doctor if wanted, there are both men and woman Doctors.
    .
    Thankfully my new Doctor is not only very thorough but he is also a Christian, although he has a lot of Patients who only want his care which means longer waiting times, I never feel rushed with him and he takes an interest in me as a person of worth but he is my Doctor and I respect him as that too.
    .
    Thanks again for sharing Sheri on something that concerns us all, Medicine when used properly is a gift from God and so are dedicated, compassionate and committed Doctors who provide the care we need but God is the only Healer, we Thank our Doctors but we Thank Him first.
    .
    Christian Love Always – Anne.

    • Anne – Thank you for reading with me and commenting. I’ve often felt I’d wait in line for whatever time it took if I were sure I’d reach the doctor I really wanted to see. I don’t have the difficult time getting to my physicians as I do for Tom and I know in my heart that’s all tied up into discrimination against those with a mental health diagnosis. Tom went into cardiac arrest this past week because I could not get an appointment for him with the doctors he needed to see. In my opinion, that’s about as bad as it gets.
      I’ll always remember a surgeon Tom had several years ago who asked if he might pray over Tom, as we held hands, before he and Tom went into surgery. I’d been so afraid and suddenly I knew, everything was going to be okay.
      Medicine is becoming more and more complex and as consumers into today’s market, it’s our responsibility to be aware of the shifting market.

  8. Our town’s main doctor closed his doors, at the end of last year. He reopened a concierge practice that only accepts diabetic and cardiovascular patients. If you qualify medically and insurance wise, to be part of his practice, the concierge service costs an additional $156 a month, per patient, on top of any other co-payments you may owe.
    While $156 per month, may not sound like an exorbitant amount of money, consider that the majority of this doctor’s practice were Medicare patients, on a fixed income. His move left hundreds of elderly folks in the position of using the local urgent care (not ER) facility, for their medical care. We have 2 other doctors, in town. One doesn’t accept Medicare or Obamacare insurance and the third doctor’s practice is full. Hopefully, he will soon have a PA, as he does treat Medicare patients.
    I don’t know what to think about concierge medicine- I know I’m scared- my monthly health insurance premium ($891) now officially costs more than my mortgage (my escrow went down) and I’ve had the humiliating experience of being told I’m not welcome at a doctor because I have Obamacare lol.
    I think it’s just another step in eliminating the middle class.

    • Ugh – urgent care is not a good place for primary care. They are there when your regular doctor is not available and you don’t want the hassle of the ER plus the bill will be cheaper than the ER. However, urgent care is, IMO will never replace having a primary care doctor (at least not the value of having a primary care doctor). I relented and took Tom to our newest urgent care and that’s how I got him to the ER by ambulance and our insurance will pay the ambulance 100% by the urgent care doc ordering it.
      The great thing about urgent care sending Tom by ambulance is that it got us into the back immediately where we could get help and otherwise they would probably have made us wait until Tom was dead. Did I happen to mention that our ER is miserable?

  9. This is all alien to me Sheri, here in the UK, though what I can identify with is the need for good primary care – a consultation with a GP is usually a 5 minute appointment focussing only on the matter at hand, with little in the way of prevention – fortunately I rarely need to visit a doctor.

    • Hi, Andrea – Thank you for stopping in to read and comment. Last night I read an article in I believe The Atlantic Monthly about the inability of the UK to sustain the level of care currently provided. I kept the article as I’ll want it for reference material in a later blog, I’m sure. The numbers are always scary. It doesn’t matter what country I’m reading about. Healthcare costs are out of control and other than not treating patients, no one seems to have a fix for the problem.
      You are so right, good primary care is the cornerstone of medical care. I’ve also been doing a lot of reading about patients not being compliant with their physicians instructions. It seems if we don’t all cooperate in some manner, the entire system will collapse.

  10. My dear Sheri …it often feels that medicine … is marketing widgets on Paid Programming. However, I do see that with the rising costs of care these days, people have their backs to the wall. I have never heard of this and doubt I can take advantage. As always you inform and educate me in areas where I am clueless … and sadly add … powerless 🙂

    • Florence – Hello my friend. I’ve learned a great deal about concierge medicine since I posted this blog. It’s amazing how much material keeps popping up even after all the research. The most important thing I’ve learned is that when we did get in front of Tom’s internist on Tuesday and let him know what had happened as a result of not being able to get an appointment with him, he advised us of how [things were supposed to work in his office]. I have to smile because otherwise I would throw my hands into the air and run into the street screaming. I now know the next time we have a need for urgent care that Tom’s internist will be available within 48 hours. If not, I have his private cell phone number!!! As we left his office on Tuesday, the doctor was yelling for his staff to gather in his office. I’m certain they were about to get a keen chewing out as they had done everything but what the doctor wanted. I’m so relieved to know we now have urgent access to Tom’s internist. What more could I ask for?

  11. M-R says:

    We have nothing like this, and to be honest, I hope we never do. I think the Australian health system is pretty good – far from perfect, of course !, with most of the problems coming from the usual (i.e., bureaucratic) level – but it is definitely a lot fairer than concierge medicine. This can only be described as medicine for those who can afford it.
    I’m grateful that if it ever arrives in Oz, I’ll be long gone.

    • I hear you, M-R. I’m also wondering if the physicians signing up to practice concierge medicine are doing so in the best interest of the patient or to simplify their life style.

      • M-R says:

        Would you believe, Sheri ? – I heard YESTERDAY that we do appear to be trying to introduce the same thing ! Our wonderful guvmint sees it as yet another way in which responsibility can be palmed off …

        • M-R: Wow, small world isn’t it? How does the Australian healthcare system compare in solvency to the U.K. In the March 21 issue of New Scientist there’s a fascinating look at the crisis the National Health Service faces immediately. I hope to compare some of the findings to some of the same findings we have going on in the US and what I’m reading about Canada, France and numerous other countries. Basically, it’s all about the money. New Scientist stated, “Across almost every measure of health, those with less money get more disease.” I think it will be interesting to watch the general elections in the UK and see how their health care crisis plays out in the political lay of the land.

  12. Patty B says:

    Very interesting – I have not heard about this but right now our Family Dr is no longer allowed hospital priveleges in the hospital (as others) when you are admitted you must see the hospital physicians. Not my idea of good care – because who knows you better than your famil dr?? It is one of the new systems provided by this wonderful new health care act. I have a feeling Dr. D is getting ready for early retirement – don’t know what I will do then. But since he no longer needs to be in the hospital he has extended his hours to early morning to later at night. So that is a blessing, and he is always available to us. Now something else to learn about. My head is swimming with all of this new stuff. thanks for keeping us updated.

    • Patty – It’s so nice to see you, my friend. We have the same situation in our city wherein all the doctors at the local medical center work for the local medical center and do not see private patients outside of the hospital. In the same vein, you cannot take your own doctor with you into the hospital should you have to have hospitalized care. I agree with you completely that your doctor should be able to follow your care into the hospital. Not only does he/she know your health better than anyone else, you the patient have a greater comfort level. Additionally, the hospital is taking a significant revenue stream away from your physician and getting away with it!
      What happened here is the hospital took all of the great doctors from the local community because they could offer them great salaries without the headaches of a private practice. As far as I know, the emergency room is contracted out. The emergency room used to be excellent but has since gone to ruin. You’ll be hearing more about our crumbling health care system in Conway when it comes to urgent care in the next few blogs.
      Having the excellent doctors employed by the hospital has raped the local community of excellent health care and thus if you or a loved one are a complex patient, you are forced to find care in Little Rock. Of course that’s the category Tom and I are in and as we age, I project our healthcare will require that we move closer to the center of where it’s available. I do not want to live in Little Rock but we may not have a choice.
      Stay tuned, my friend. The battle isn’t over yet. Tricare is acting as if they owe the military nothing and United Health Care is backing that legislative movement. Everyone within the military community [both active duty and retired] needs to join the advocacy chain every opportunity they get in hopes of guaranteeing what was promised when those we love sign on the dotted line.
      Sending you love and prayers, Patty.

  13. Sheri, I keep you and Tom’s health in my thoughts and prayers. I am alarmed to hear that he had cardiac arrest last week.

    • Kitt – Thank you for your kind words. Had we been able to access the health care Tom needed, he would never have gone into cardiac arrest. This was a direct result of the mentally labeled person being treated as a second class citizen. During our struggle over the past eight months, I’ve seen the doctors eyes glaze over and have them disregard Tom when he’s been explaining what’s been going on with his body. This treatment of individuals with a mental health diagnosis has to stop and it has to stop now. For 8 months I’ve fought the medical establishment and for what — so that my husband can go into cardiac arrest due to the lack of attention of the medical establishment. Needless to say, I’m angry.

      • Your anger is warranted. I must admit that I, too, have dismissed symptoms of physical illness in both my son and husband, thinking their symptoms are psychosomatic or stress-induced. Then… I get gastroenteritis, and I realize, oh, they really are sick. It’s hard when I’m trying to get my kid to school regularly. Besides, even if they are getting sick due to psychosomatic causes, they are REALLY in pain and really sick.

        • Kitt – many of the most severe forms of cancer have now been traced back to stress. The most aggressive form of breast cancer is linked directly to stress. I’m reading more and more research about how the intestines are the brain of the stomach and our emotional state has more to do with our gastro diseases than any other cause. I have more gastro issues than any other and I attribute them all to the stress I’ve lived through in the past or am currently dealing with.

          • I have SIBO (small intestine bacterial overgrowth) & understand that it affects moods. When I keep to a low FODMAP (a long list of fermentable carbs) diet, I do better. Somehow I’ve got to get my family healthier.

            • Kitt – So true. Tom and I have both had to move away from processed foods. I haven’t had white flour or sugar in years but we have to be more restrictive. I’ve believed for a long time that when my gut isn’t happy, no one is happy. Making sure everything is 100% natural is tough but I ate that way for years. I’d never felt better. Then, I slowly made by way back into some processed foods and know I definitely must get away from them again. Tom is a harder sell but knows he has no other choice or he won’t have a chance at survival.

  14. I love options. I have heard of this concierge care. I don’t know enough about all plans, all laws, and all options. But I do know that what is being forced, is not working. And it’s only getting more confusing and more difficult to understand.

    • Depending on age, what insurance coverage you may already have locked in (employer type, etc) and if you have multiple chronic conditions — I still believe there’s a place for concierge medicine in everyone’s life if it’s financially possible. In this day of rocky healthcare availability we each must have a doctor we can reach immediately and have our concerns addressed immediately.

      • What I’ve read, I would “enjoy” having this. If I could afford it. And if my current doctor was doing it. 🙂 I really like him and his staff. 🙂

        • I’m of the opinion that once I have a doctor I respect and especially if I can get past his staff to see him, I won’t rock the boat to ask for change. I’ve completed hundreds of hours of research on the subject of concierge medicine and it does have its place. By asking additional questions of Tom’s internist this week, I learned Tom doesn’t need concierge medicine. I’m thrilled I did the research and was able to talk with him intelligently and know the ups and downs. Tom’s internist and I are on a whole new page of understanding and he’s promised me immediate access to him whenever I need it for Tom – we’ll see what happens when the next emergency rears it’s ugly head. For now, I love the man. Let’s hope it’s not a short lived romance.

          • You are amazing Sheri. It’s wonderful news to hear you have a doctor to love after all of the strife you’ve been through with medical care. You are an amazing advocate. Here’s to continued success and wonderful relationship with this good doctor!

  15. ksbeth says:

    i am all for health care options, the current programs in place, do not work well for many people. i think it would depend on the patient, the family, and their needs. i am open to all ideas.

    • Hello Beth – Thank you so much for stopping in and commenting. You are so right, the current programs in place do not work. I’m learning more and more about how the Affordable Care Act policies are not working for the individuals who have them. You know how Medicare doesn’t work, I’ve written enough about how Medicare has abandoned the very population it’s meant to serve. As I wrote in the blog, I have every intention of searching for a Concierge Physician for Tom. I cannot allow a repeat of the past 8 months. Our so-called healthcare system is killing patients. What if Tom didn’t have an advocate? How many are dying due to lack of care they cannot access?

  16. willowdot21 says:

    Sheri thank you for this really interesting and informative post. I am simply dismayed by the fact that really if you don’t have the money ypi suffer. In the UK we have NHS ( national health service) that is medical care we all pay for through national insurance taken at source from everyone’s wages/salery. We also can have privete medical care payed by insurance extra to NHS. Our NHS is struggling with alsorts of problems, that said of you need it is the best ( usually nothing is perfect). If fear for our children and grandchildren as I think eventually the UK will end up like the States people having to pay for everything.
    I am sending you and Tom hugs and healing vibes . thinking of you both. xxx

    • All hugs and healing vibes accepted. I believe we’re in for a long fight world-wide in all developed countries to find the medical care we each pay for in one way or another. I’ve learned a lot in the past 8 months and I know the lessons aren’t over yet. At the same time, the challenges are far greater than they ever were for mental health. I can’t believe I actually wrote that last sentence. I thought nothing would ever be more difficult than finding help for Tom’s bipolar disorder but he’s been symptom free for a long time. Now, this dear man’s body is falling apart before my eyes and I will get him help.
      When Tom went into cardiac arrest this past week and all because I was unable to get an appointment with his internist, I said to myself, “This is the beginning of an all new game plan.”
      On a lighter note, spring has arrived here. I’m afraid to prune my roses for fear of cutting them all the way to the ground in a fit of rage at our health care. My beautiful roses don’t deserve such treatment. Therefore, I’ll target my congressmen as they are on spring break and Congress adjourned with some of the most important bills regarding Medicare unresolved!

  17. Angie Mc says:

    Sheri, I’m relieved to see you back and to be updated on Tom. Oh my, I continue to cheer you both onto health and medical care victory.

    I’ll need to read your detailed post again when it’s not so late at night. You make excellent points and I agree that access to the right care at the right time is key.

    • Angie – My posts will probably continue to be further apart as I spend more and more time as a 24/7 caregiver and another 15 hours or so a day tracking down healthcare. With this being spring break for Capitol Hill, it’s time for me to hit ‘the boys’ while they are home with the havoc they’ve allowed to happen. I refuse to accept what’s going on with health care in our country.

  18. A Concierge Physician might be right for some people who have the money but for me I am satisfied with what I have. My hospitalization last August and subsequent pacemaker installation did not cost me one cent. I have Medicare and (NALC through the VA). I’ve had the NALC for about 25 years or more so there is no need to change plus I could not afford that kind of care anyhow.

    I hope that this type of medical care will be just the thing for your husband.

    • Yvonne – I’m delighted Medicare in partnership with NALC is working for you. We will use a combination of all our insurance companies for Tom as well as finding a Concierge Physician. I must have someone that can and will treat him immediately instead of allowing escalation to something as critical as cardiac arrest! His coughing was so severe and had been going on for so long, it had caused too much stress on his heart – even I knew that. In addition, his lungs were so inflamed he was on the edge of pneumonia. I cannot allow this to happen again. Tom deserves better and I deserve better. The added stress it places on me as a caregiver is too much.

      • It sounds great to use a concierge MD and yes indeed you can’t put a price on exceptional; health care. I surely hope that Tom’s health will now be improved and that your stress level will be significantly decreased.

        • Yvonne – You’ll love my internist approach when I went in for a regular follow-up visit. We talked about my level of stress – actually he spent a little over an hour with me although I was only scheduled for about 15 minutes. I like my internist and have been seeing him for 8 or 9 years and we have a great relationship. He’d been concerned about my possibly having gotten pneumonia again as I’ve had it several times in the past, although I’ve had the preventive shot. He ordered the extra super-duper preventive shot. [In case you haven’t had the new vaccine, please ask for it]. Medicare pays for it as a preventive.
          Anyway, back to the stress reduction. His prescription reads:
          Tell no one where you are going, what you are doing, or how to reach you. Some one else will be in charge of Tom’s care. You are not to check in.
          Go anywhere you want but make it a location you love and feel safe.
          Stay a minimum of two weeks.
          Do whatever you want, whenever you want, however you want and if you want to engage in conversation or other activities – do it with only those with active intelligent minds.
          Unfortunately my insurance won’t pay but it sure sounds good, doesn’t it.

          • Well now, can you abide by your MD’s suggestions? I sincerely hope that you can for your health.

            I didn’t know there is a new pneumonia vaccine. I’ve had two of them, about 8 years apart with the last one maybe two years ago.

            • Yes, the new vaccine has just been released. It’s being given to children and individuals over the age of 65 considered at risk.
              As far as abiding by my internist’s RX, the answer is unfortunately no. I’m a full-time caregiver and I don’t have the luxury of having someone else step in and take my place. Tom and I are both without extended family.

  19. Fascinating background, Sheri. I would consider it, especially if they take Medicare. I’d love a critical care program and a monthly concierge plan, but Obamacare requires me to have prenatal care and maternity benefits (at 62, I won’t need that much). I’m waiting to see what is going to happen.

    • Jacqui – The beauty of Concierge Medicine is you are allowed to bypass the Obamacare requirements. Concierge Physicians are required to provide all preventive care, prenatal, etc. Therefore, individuals with Concierge Medicine are able to buy a much cheaper plan through the Affordable Care Act for hospitalization, etc. [You won’t need hospitalization insurance if you take Medicare at age 62, as far as I know. I know it comes at age 65 but I haven’t researched age 62].
      From my research, some Concierge Physicians accept Medicare and others do not. One of the great premises behind Concierge medicine is that you as a patient are not one of thousands. You get individualized attention when you need it. Therefore, even if they do accept Medicare, you will still probably have to pay a small fee. Some doctors that accept Medicare and other commercial insurances are accepting patients around $140. Additionally, some of the doctors are purchasing medications and passing them thru to the patient at cost with no mark-up whatsoever.
      With Medicare Part B, that would pay the office visits of any specialist you might need. Everyone is covered for hospitalization under Part A at age 65. If you are seeking full retirement at 62, you’ll need to check if Medicare Part A will lick in at 62.
      I’ve been researching critical care programs along with end-of-life [yep, two different programs with some discussions] and hope to have a blog within the next 6 months or so. As you can imagine, thousands of hours of research goes into each blog – I can’t pluck this information out of thin area and I know you know this. I have a strong background both legislatively and within the government when it comes to health concerns, but something changes every day. We must be careful and hyper-vigilant.
      I hope I haven’t made this more confusing for you.

  20. Terry says:

    I have never heard of it. A doctor over the phone. My first thought was hackers breaking into all my information. What is the price to have this and is it everywhere?

    • Terry – Concierge Medicine is not available everywhere. Information would never be solicited over the telephone. I suggest you google concierge medicine and read up on the subject. It’s a new movement among primary care doctors breaking away from the traditional ways of practicing medicine and offering individuals another choice. If memory serves me correctly, you are on Medicare. Therefore, you would want to research carefully to see if this would enhance the care you already receive. I think you told me you live in a small town and if that’s the case, you may not have the problems of receiving timely care many of us have living in larger cities. I talked about the price of concierge medicine in my blog. I hope this helps. Sheri

      • Terry says:

        Thank you Sheri, I will just wait for you to send your diet information

        • Terry – I found some really good information for both of us last night. I need to pay more attention to what I’m putting in my mouth also. It’s easy to go astray. I’ll try to get a message off to you soon. Hopefully in the next week. Tom is taking up a lot of time but I also know you understand caregiving can be more than just a little mind boggling at times. Remember, I love you and so does God.

  21. Elyse says:

    I think it would depend on the patient — I can see it, but for me, little I get needs 24/7 care that I don’t already have access to. Interesting to ponder, though.

    • Hi Elyse – In pondering the pros and cons of Concierge Medicine, I see a diverse population base where it fits great. If we were a young family starting out I would be tempted to grab onto finding a Primary Care Physician this way. Far too much time is spent waiting to see a doctor and this way, the time slot would belong to you and you alone.
      I also like the emphasis on preventive care. In the case of Tom’s non-care that I wrote about above, it could have been prevented had we had access to a physician understanding the concept that Tom needed relief from his virus and constant coughing. Instead, I’m estimating at this time that his medical charges will come in around $45,000 due to his internist not having the time to see him for a 15 minute appointment.

  22. When I left Seattle in 2002, most of the primary physicians were charging patients a monthly fee to stay on their books – in addition to accepting insurance reimbursement when they delivered specific services. For most of them, it was the only alternative to declaring bankruptcy, as insurance and Medicare reimbursement had dropped so low they couldn’t cover their overhead expenses.

  23. This is amazing. I’ve never heard of it yet I would be interested in jumping on board. My only question is, what about things like a sigmoidoscopy or a neurologist? Is that where I would still have to carry private insurance? SOMETHING has to happen with our healthcare system because things are out of hand. My husband has to chip in each month for our medical benefits provided by his union coverage but his portion to pay doubled last January! What?

    • Patti – Welcome to the club. All insurance is expected to double or even triple this coming year and many employers are expected to drop health insurance completely. During the years I worked for the government, I always had to pay a share for my health insurance and now that I’m retired, I carry the majority of the cost. However, with that being said, it’s still important enough to me to not drop it.
      With very little searching, you’ll probably find many concierge physicians in the bay area. Of course, you’ll have to do your research to make sure you find one that meets the needs of your family. I think that will always be one of the biggest challenges.
      While doing my research, most articles I read made the argument individuals could lower their insurance cost due to the concierge docs meeting the requirements of the Affordable Care Act. Therefore, you’d only need to be covered for the high-end medical cost.
      I personally don’t see our insurance cost ever going down. The industry itself upset so many for so long, it’s a industry that’s brought much onto itself. I despise what’s happened to our health care and I don’t need more emergencies with Tom like I had this past week.

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