Redefining the Doctor-Patient Relationship

About 10 years ago, the medical doctor I had seen in years past sent me a letter telling me he was moving to a "concierge practice." It took me a few minutes to realize who he was, as I had only seen him 2-3 times in the previous 20 years.

His letter let me know he would only take a limited number of patients; for only $5,000 per year, I could be one of those patients. The purported benefits were better access, personalized care and more time during visits. This fee only included his services. All tests, lab work, specialists, etc., would be additional charges.

Needless to say, I passed, and have yet to find a need to replace him.

However, since then, I have become more aware of the concept of a medical concierge practice. It appears to be a way for general practitioners to avoid the headaches of insurance reimbursement and begin to practice their craft the way they envisioned in medical school. While most MDs carry 3,000-4,000 patients apiece, concierge MDs only work with a few hundred. Of course, their patients are limited to those who can afford the excessive fees.

A new twist on this concept recently emerged in Wichita, Kan., with a program apparently started by Atlas MD. A group of medical doctors has taken the concept of a concierge practice for the elite and translated it into something that could change the face of health care for many middle-class families.

Instead of $5,000 per year, their rates are $50-$100 per month for adults (male or female) depending on age. Children (with at least one parent membership) are only $10 per month. This means a young family with two children could enjoy a dedicated MD for only $120 per month. According to the Atlas MD website, there are numerous benefits to this approach:

• Unlimited access to your doctor: After-hours, weekends, holidays – there's no bad time to receive excellent medical care.
• Extended, relaxed visits: There's never a question you won't have time to ask.
• Same-day and next-day service scheduling: You'll be part of an intimate family practice consisting of approximately 600 patients.
• House calls: You can choose to come to our office, or the doctor will come to your house at no extra cost.
• Full access via technology: Reach our team and other medical information via webcam, email, text and more.
• An annual executive physical fitted to your personal medical needs.
• Diagnostic and procedural benefits at no extra costs.
• Wholesale labs and medication costs: We'll pass our benefits right on down to you.

This last benefit intrigued me, so I did a little follow-up. Atlas MD was recently featured in an article in U.S. News & World Report¹. The article notes: "Medicine or lab-work, meanwhile, carry wholesale prices: $5 for heartburn medication, for example, or $6 for a prescription to treat migraines. Blood work that might cost $30 out of pocket under an insurance plan instead costs just $2."

Dr. Doug Nunamaker, Atlas MD's chief medical officer, is quoted in the article: "I can order-in medicines because the clinic's income is based on membership," Nunamaker explains. "I don't need to make money dispensing medications – I can get 1,000 Prilosec pills for $55, and I can dispense them to you for a couple [of] dollars. It's significantly less expensive." (By comparison, Walmart offers Prilosec [only 42 tablets] online for about $24.)

These services can be combined with "both a major medical plan and a health savings account." Atlas works closely with a health insurance broker who has "been able to save young families nearly $1,000/month and many businesses 30-50% while providing a higher level of care."

This new model is likely to be extremely popular with health care consumers and make quick inroads in most communities. MDs, like DCs, are fed up with insurance running health care – and they are beginning to do something about it.

As this model takes hold, it will change the doctor-patient relationship in a number of profound ways. Patients will expect more and be frustrated when they can't get it. It will also set some new standards in doctor access, some of which are probably overdue.

In reviewing the list of potential benefits as stated by Atlas MD above, you may want to ask yourself: What changes would you need to make to your practice if the above benefits were expected by your patients? Do your patients have access to you when they need you?

The health care world continues to shift. This trend could take us away from incessant insurance oversight and closer to consumer-oriented health care.

It may be time for you to rethink how your practice is participating in these changes. This is your opportunity to lead change, rather than react to it. In so doing, you may help reshape your practice, the chiropractic profession and the health care system all at once.

Reference

1. Neuhauser A. "Physicians Abandon Insurance for 'Blue Collar' Concierge Model." U.S. News and World Report. April 1, 2014.

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