Obamacare or Concierge Care?

I recently received a letter from our personal family physician, who we've known for over 20 years. The letter began with a paragraph stating that he was leaving the group practice which he had been a part of, and had joined something called "PartnerMD, a membership medical practice that provides excellent primary care."  He went on to state that "PartnerMD's model will enable me to provide attentive, personalized medical care with an emphasis on prevention."  My take-away of this first paragraph was that I would now have to pay a membership fee to be able to see our family doctor.  This membership fee would of course be in addition to whatever charges we would accrue as a result of visiting our family doctor.  The stated advantages of PartnerMD membership were "same or next day appointments, wait times of 5 minutes or less, direct access to our doctor via cell phone and e-mail, 30 minute office visits and much more..."  If I responded within 30 days of this letter, I would receive $200 off my first year membership fee, and I could pay this fee on a monthly, quarterly or yearly basis.  I didn't call to find out more.  The discount alone spoke to how much the total membership  would be.

In my lifetime, I've seen medicine change dramatically.  I can recall times when, as a child, my mother would call our family doctor because I or one of my brothers was running a fever.  Dr. Feinberg would actually come to our house, check on us, and prescribe accordingly.  We were not wealthy, and I'm sure that Dr. Feinberg made a good living, but fee for service medicine was inexpensive enough for my parents to be able to afford a house call.  Talk about concierge care!

The question to ask is what has changed healthcare in less than 5 decades?

Certainly, technology has advanced over the years and this creates new costs.  But ask any doctor about what practice stressors create the desire to go to the concierge model, or alternatively, to check out of practicing medicine entirely; you will hear in no particular order such issues as:  litigation, increasing practice overhead costs, our federal government imposing itself upon healthcare, and the reality of ever decreasing insurance participation. In other words higher deductibles and more limitations on payments and more red tape to get paid or stay paid.

What was surprising to me about the selling points of the concierge medical model?  Our practice had always offered:

• Same or next day appointments
• Wait time of 5 minutes or less.
• Direct access to me via cell phone (864-905-7053) and email (drmruz@eastsidechiro.com)

ALL of those features with the exception of one...the 30 minute office visit.

When a practice member is seen for a routine check up, we wouldn't monopolize their time.  They could expect a 15 minute routine office visit experience.

New patients?  If you went to our practice website online resource to fill out your paperwork before arriving at our office, then yes, expect a 30 minute office visit.  Fill it out in office?  Expect at least 15 minutes just to fill it all out, thanks to our Federal Government and their requirements.

All of this, and no yearly concierge fees.  Certainly the overhead for a chiropractic practice, while escalating, doesn't match what my medical friends have to deal with.

But what about Obamacare?

I had discovered recently that the statement by our president: "If you like your healthcare plan, you can keep your healthcare plan" stated over and over again while he was attempting to sell America on the "Affordable Care Act" was  a falsehood.  We received a letter from South Carolina's Blue Cross and Blue Shield which advised me that I couldn't keep my plan.  

The plan that I had purchased in July of 2010. 

The plan that I liked.  

The plan that I had intended to keep.  

Thank you Mr President.

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