Apparently doctors have left their jobs too

[catherine]

I was just reading an article about a radiology clinic back in Austin laying off long-time staff right now - this is a company that has been there for years. A year or so back, the bulk of the organization was acquired by private equity firms for whom only the bottom line matters. Little bits left were sold off to some of the doctors who practice there. Ditto with MIL's assisted living - it was also acquired recently by an equity firm and the service has become deplorable. So much of this going on in the health care world.

Consolidation of healthcare systems has been going on for a decade or so and is not going to stop. Buying physician practices is in the mix as well.

[JaneV2.0]

he can fancy himself that way if he wants. But a healer to who? Bet he doesn't take insurance or Medicaid/Medicare, bet his out of pocket cash rates are out of reach to even the middle class. So he could just say "I used to be a doctor to everyone, now I'm a doctor to the rich" and be as accurate about it.

I've priced concierge car, and didn't find it unreasonable. This guy works with an aging clientele; he might be a grifter, but I doubt it. A lot of doctors don't like to have to toe an unreasonable line between insurance companies and Pharma, so I suspect this is a trend.

[bae]

I've priced concierge car, and didn't find it unreasonable. This guy works with an aging clientele; he might be a grifter, but I doubt it. A lot of doctors don't like to have to toe an unreasonable line between insurance companies and Pharma, so I suspect this is a trend.

My concierge doc's rate for my age range (42-64) patient is $2,800 annually ($234/month). I don't find that unreasonable at all. I then get a significant discount for being a first responder, so I'm paying ~$2250/year.

My doc is one of the finest ones I've worked with, was one of my medical instructors, and when there was a management kerfuffle at our local medical center that was interfering with quality-of-care, left and started her own no-insurance/no-paperwork practice. She can now see a lot more patients, and provide them better whole-patient care.

Calling this "grifting" or only serving "the rich" is a bit silly. I'm spending less now than I was when I was using the state healthcare/insurance/service that is otherwise available to me. And getting better care.

For reference, a couple months ago I dislocated a shoulder and we managed to put it back together in her office with a couple of assistants. My total out-of-pocket costs were some minor sum paid to the local medical center for x-rays to verify it was back, and for a PT doctor to fly over and give me a couple of ultrasounds and show me how to do the PT on it to recover range of motion and strength. The PT doc only charged me for the actual exam, and not his cost to fly here. The cost savings from this single incident likely paid for several years of her services.

[iris lilies]

My concierge doc's rate for my age range (42-64) patient is $2,800 annually ($234/month). I don't find that unreasonable at all. I then get a significant discount for being a first responder, so I'm paying ~$2250/year.

My doc is one of the finest ones I've worked with, was one of my medical instructors, and when there was a management kerfuffle at our local medical center that was interfering with quality-of-care, left and started her own no-insurance/no-paperwork practice. She can now see a lot more patients, and provide them better whole-patient care.

Calling this "grifting" or only serving "the rich" is a bit silly. I'm spending less now than I was when I was using the state healthcare/insurance/service that is otherwise available to me. And getting better care.

For reference, a couple months ago I dislocated a shoulder and we managed to put it back together in her office with a couple of assistants. My total out-of-pocket costs were some minor sum paid to the local medical center for x-rays to verify it was back, and for a PT doctor to fly over and give me a couple of ultrasounds and show me how to do the PT on it to recover range of motion and strength. The PT doc only charged me for the actual exam, and not his cost to fly here. The cost savings from this single incident likely paid for several years of her services.

I’m curious to know what you get for that $234 a month. My direct care physician charges me $80 a month and I’m quite a bit older than you, so I am in her oldest category of patients, I think.

When she takes a CBC for instance, does she pay for the lab work? For me, I use insurance for the actual lab work. For the blood draw my direct care fee covers that as well as the accompanying company in exam, visit, etc.

each office, be it concierge or direct care, will cover different things I’m sure. Since mine seems to be a pretty bare-bones direct care, I don’t expect a whole lot from it I just like the convenience of having a doctor so close. There are other doctors in town but I like the idea of direct care.

her charge for children is $15 a month. One of the moms down the street told me that they use this direct care physician as their back up physician because it’s pretty much the cost of deductible on their insurance for visiting their regular physician further out of town.

[iris lilies]

Also bae, Do you have some kind of insurance for bigger events? You probably have some sort of ACA insurance even if you don’t use it.

[bae]

I’m curious to know what you get for that $234 a month. My direct care physician charges me $80 a month and I’m quite a bit older than you, so I am in her oldest category of patients, I think.

It covers office visits, any procedure she can do in her office, any lab work she can do in her office, blood draws for labs sent to the big lab, GP management of my whole health, well-patient care, vaccinations, yada yada.

I still have to maintain health insurance, which covers labwork elsewhere, procedures and specialists elsewhere, and that sort of thing. I pay $1.89/month for the WA State "silver" level plan through our state exchange, because I have basically no "real" income.

Our local medical center is currently operated by an off-island larger medical provider, and was going through a troublesome transitional period trying to get a crew of doctors/nurses/PAs who could practice there. Scheduling was uncertain, and having the same doc from visit-to-visit was uncertain. I hear it is getting better, but it was too zany for me to deal with, and the past incarnations of that clinic have been notably bad. Getting appointments there under the new operator is a bit of a pain, and after-hours care sucks. (My doc will make after-hours housecalls if need be).

The other option people here use is to go off-island, but that eats an entire day of your time, $50 in ferry fees, and the ferry system has been very unreliable and wonky since the pandemic. Between gas, ferry fees, food I usually budget at least $100 simply to pop over to the mainland.

My doc also told me just the other day she'd be happy to see my 26-year-old daughter for anything that pops up while she is visiting from the UK, which is good as my daughter isn't covered here in the US.

[iris lilies]

Your service sounds similar to mine. However my direct care physician employs a nurse practitioner and that’s who I saw last time I was there for an annual visit. Also I had allergy test performed by a tech. So for less money I’m seeing less educated/experienced personnel.

I could make an appointment to see specifically the physicisn but it’s just not that important to me who I see.

The cost difference is reality that things cost more on your island, especially real estate. If my physician is paying $1000 a month for her office space that would be the higher end of what I estimate she pays