The Concierge Physician Mob

Summary

Concierge medicine in the author's community has become prevalent, yet it remains an uncontroversial topic in the media, despite creating a two-tiered healthcare system where swift appointments are guaranteed only to those who can afford additional fees.

Abstract

The article discusses the rise of concierge medicine in a community that has experienced the effects of 50 years of Reaganism, where access to healthcare is increasingly difficult. Patients face long wait times for appointments with general practitioners (GPs) and specialists, sometimes extending up to a year. The situation is exacerbated by concierge doctors who advertise their services in a deceptive manner, offering quick appointments for an undisclosed fee. These practices are often not covered by insurance, making them inaccessible to those who rely on in-network providers. The lack of coordination between concierge services and the traditional insurance system poses additional challenges for patients who may need to switch providers, leading to delays and potential issues with pre-existing condition coverage. The author criticizes the existence of a two-tiered system where those who can pay have access to better healthcare, while others are left with substandard service, likening the concierge fee to protection money demanded by the mob.

Opinions

The author perceives a bias in the media for not addressing the issues with the growing acceptance of concierge medicine.
There is frustration over the difficulty of securing timely doctor's appointments within the traditional healthcare system.
The author is critical of a concierge doctor who promoted their services without transparency about costs or insurance coordination.
Concierge practices are seen as creating a divide in healthcare access, favoring those who can afford out-of-pocket fees over those reliant on insurance networks.
The author points out the lack of clarity on how concierge medicine coordinates with insurance for necessary medical services like labs, tests, and treatments.
There is skepticism about the sustainability and fairness of a healthcare system where concierge patients receive expedited care at the expense of others.
The author equates the concierge medicine model to a form of extortion, similar to the mob's protection racket, where additional payment secures preferential treatment.

Demanding protection money for service

In my community, if we have any of those left after 50 years of Reaganism, concierge medicine has become almost the norm and yet remains uncontroversial if you listen to the media’s resounding silence.

I’ve asked people living in my area about their experiences making doctor’s appointments. Many could relate. It’s hard to get an appointment. Appointments for GPs and specialists can go out months or up to a year. We had a discussion going on an online community group. That discussion was broken up by a concierge doctor shamelessly advertising her group while hiding her MD and partnership in the group. When I figured out who she was, I asked a few questions about how to coordinate their services with insurance requirements. I received no answer other than call us and sign up. Their website FAQ is sparse on details and contains no fee information. For the low low cost of so high a cost they won’t tell you what it is unless you call, you get guaranteed swift appointments. Isn’t that nice.

For me and many others, none of the doctors in the concierge practice are in-network, and none can be assigned a PCP. These concierge practices are out of the question for those dependent on incompatible insurance. They’re thin on explanations of how this is supposed to work if you get a diagnosis from a concierge doctor and then have to opt back into the insurance system for labs, tests, hospitalization, surgery, or treatment.

Reviewing the network and PCP requirements, it doesn’t look like there is any coordination. Why would there be? If you went to an out-of-network doctor, that won’t be covered. You have to start over with an in-network provider, get a new PCP, and wait the long waits. If pre-existing condition exclusions were still legal or again become legal through an act of the hatemonger congress, is that another problem? I imagine someone will find out the hard way.

I complained that these concierge doctors have opted out of the insurance system they favored during the health care reform debates of the early 2000s. I was corrected. I’m wrong. One woman, outside of our community, assured us that her concierge doctor is in-network under her insurance. If she’s fine, then it’s not an issue because no one else’s different experience matters, right? This is the new America.

But then I thought about what she was saying, which was even worse. She pays the concierge fee to see her doctor in a day or so rather than waiting. She’s lucky in that her concierge doctor is in-network, and her assigned PCP is under her insurance. Great. The best of all possible worlds as she gloats. But is it really? The same doctor with the same patient load and same schedule sees the concierge members quickly and leaves the rest of their non-concierge insurance practice in a long, hopeless line. No prepay, no care for you!

This woman is out there defending concierge practices, apparently unaware that she’s paying additional money to get the same level of service we all used to get and helping the service providers, doctors, deny that service to others. It reminds me of how the mob used to damage stores and threaten store owners, demanding protection payments. The payments to the mob protected the store owners from violence caused by the same mob demanding the money. Other than the white coats, what’s the difference?