What is the average annual cost of a concierge doctor?
Imagine being able to contact your primary care physician at any time. Someone who is familiar with your whole medical history, responds to your emails, messages, and phone calls 24 hours a day, seven days a week, and makes same-day appointments when you’re sick. And it’s all for a monthly cost of around $80.
If that sounds appealing, you might be enticed to join up for direct primary care (DPC), a type of tailored medical treatment being offered by an increasing number of doctors. However, don’t jump in without doing your homework—DPC isn’t for everyone.
The most significant restriction of DPC is that it is neither insurance nor a substitute for it. This form of treatment, also known as retainer medicine or concierge medicine, is best used as a supplement to an existing health plan. You pay a one-time, flat monthly or annual price with no hidden fees in exchange for practically unrestricted access to a primary care physician of your choice, not one mandated by your insurance network. You’d also have to switch doctors from your existing practice to the DPC’s.
You are entitled to unrestricted access to primary care services
According to DPCFrontier.com, a website that provides assistance and guidance to doctors who are starting DPC practices, there are around 900 such practices in 48 states and Washington, D.C. In 2015, there were 273 locations in 39 states. DPC practices provide care to an estimated 500,000 people.
Each DPC practice is unique, but they often provide basic medical services like preventative screenings, wellness checkups, and diagnostic tests, as well as minor urgent care services like stitches or rash treatment. (You’ll need coverage through a comprehensive health insurance plan for more intensive care, such as surgery or emergency services.)
Given this menu of services, many people who use DPCs may end up spending less on healthcare in the long run than they would with a standard insurance plan if they require frequent visits.
Your doctor has the opportunity to learn a lot about you
Even healthier patients may be drawn to direct primary care because of the ease and personalized attention available. You won’t have to schedule appointments months in advance, and you’ll be able to spend more time with your doctor, who will be able to learn more about your medical history.
Today’s primary care physician allocates only 15 minutes to patient visits, which occur on average 1.6 times each year. According to a University of Wisconsin report [PDF], DPC physicians spend an average of 35 minutes per session, and patients have four visits per year.
Because DPC doctors have fewer patients and have eliminated the time and administrative costs of dealing with insurance, they can spend more time with you. A conventional primary care office will have 1,000 to 2,000 patients, whereas a DPC office will have around 600.
You should set up money for health insurance
A direct primary care agreement is not a substitute for health insurance, and this cannot be overstated. That’s why most DPC doctors recommend pairing your membership with a health insurance plan—usually a low-premium, high-deductible policy—to cover things like inpatient hospitalization, surgery, and emergency services.
You must account for this in your healthcare budget. You may not be able to use a Health Savings Account to pay your membership fees in addition to the premium and out-of-pocket payments of your insurance. Because DPC isn’t considered insurance in most jurisdictions, this is the case. (An HSA, which is accessible to people with high-deductible plans, allows you to pay for healthcare bills not covered by your insurance using pretax dollars.)
Consumer protections are few and far between
At least 25 states have approved laws stating that DPC services are not covered by state insurance regulations. This reduces the expense of regulatory compliance for physicians in these practices, allowing them to charge modest monthly rates. However, this implies that most DPC patients are not covered by the Affordable Care Act’s consumer safeguards, such as coverage for previous diseases and limitations on charging more based on gender.
That could be a problem if you and your DPC provider ever disagree about how your care is managed or what treatments should be covered—for example, different definitions of what should be covered by the membership fee. According to Maanasa Kona, assistant research professor at the Georgetown University Health Policy Institute’s Center on Health Insurance Reforms, persons with health plans regulated by state insurance departments can often receive assistance from these authorities.
To discuss your medical needs for Concierge Medicine in Las Vegas NV with a female board certified internist call 702-850-22422 today.
