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Does more time with the doctor reduce patient costs long-term? — MedCity Morning Read, Sept. 15, 2009

Do boutique medical practices save patients more long-term or provide more problems in today’s health coverage? On physician gives her perspective on concierge medicine.

Amidst the talk of reducing national health care costs, concierge medicine is a growing trend, direct care physician Dr. Daphne Miller wrote in the Washington Post on Monday.

Driven by a desire to spend more time with her patients, Miller designed a practice cutting out 45 percent of the typical private practice overhead by eliminating the cost of billing private insurance companies. She does contract with Medicare. Patients pay on a sliding-scale according to their income.

Under this model, physicians take on fewer patients who pay a monthly premium for “better” service. Same or next-day appointments, more quality time spent with the doctor, and the doc’s cell phone number may cost patients anywhere from $150-$3,000 a month or more depending on the level of services required.

Solving complicated health problems with less expensive and invasive tests, fewer procedures and prescriptions resulting in less side effects and more money in the patient’s pocket, Miller learns more about her patients’ conditions simply by spending more time with them.

Miller discusses a recent study, not yet published, from Washington state which found increases in physician and patient satisfaction and objective measures of quality of care and a drop in emergency room visits, which cost an average of 10 times more than an office visit.

While boutique medicine, as it’s also called, has its supporters, there are loud opponents. If a national insurance coverage program is adopted, doctors will be in much higher demand. Out-of-pocket costs can be higher than insurance premiums. Patients with this premier care could be treated better than others, which proposes an ethical dilemma according to the American Medical Association.

Concierge medicine does solve the problem of soaring insurance costs by eliminating the need.

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