More doctors turn to fee-based ‘concierge medicine’ to ease insurance woes
Working as a hospital doctor, Guy Delorefice used to see 40–50 patients a day. Feeling pressured, overworked and not spending enough time with family, last year Delorefice started practicing concierge medicine, charging a yearly fee for access to his services.
He now sees eight–12 patients a day.
“Life was passing me by,” said Delorefice, whose practice is in Sonoma. “I knew I had to make a change.”
The only insurance Delorefice takes is Medicare. He doesn’t have the worry or overhead for billing various insurance companies or wonder who is going to pay him and when. He also gets to know his patients personally.
“It’s very freeing to be insulated from the medical and insurance industries,” he said.
While we normally think of celebrity-type patients who pay thousands of dollars a month for lavish treatment, the concierge medicine model takes many forms, and is increasingly available to more people.
Patients get more face-time with the doctor, can make same-day appointments or reach their doctor by phone. Delorefice gives his patients his cell phone number.
Cost for concierge service varies. Of the estimated 5,500 concierge practices nationwide, about two-thirds charge less than $135 a month on average, up from 49 percent in 2014, according to Concierge Medicine Today, a trade publication that also runs a research collective for the industry.
The practices are adding offices at a rate of about 25 percent a year, according to the American Academy of Private Physicians.
“The concierge model is pretty simple,” said Ellen Barnett, M.D., co-founder of Integrative Medical Clinic of Santa Rosa. “Get rid of all that overhead, charge people and see who comes. It’s a nice model, and I think it’s appropriate for a lot of patients.”
Her clinic has been operating for 15 years. It started offering concierge service as an option about 10 years ago. The service is a small part of what they do, with about 30 patients or families members out of about 2,000 active patients.
The cost for the service at the clinic is about $1,400 a year for individuals, $1,600 for couples. How much to charge is kind of arbitrary, Barnett said. It’s roughly based on the cost of one visit per month, or about $110.
The clinic takes Medicare as well and is a “very patient-centered practice.” The motivation for Barnett to offer this kind of service was to meet all her patients’ needs, which often includes phone visits.
But Medicare doesn’t reimburse for phone visits, which is unfortunate, Barnett said.
“Because so much of medicine could be done by phone. In many cases it’s perfectly safe and appropriate medical care to do it over the phone,” she said.
Some families with elderly members want unencumbered access to talk about concerns they have for them.
“Some people use it all the time, and other people don’t ever use it, so we figure [the price] comes out in the wash,” Barnett said. “Some people just like the idea they can call me any time and talk with me. It’s also good for certain people who have very complicated medical situations. Mostly, I’d say it’s just an extra level of security that they feel.”
Concierge medicine is something people usually have on top of their regular insurance. It doesn’t cover other treatments like MRIs or surgery.