[RationalExpectations]

Originally Posted by xofruitcake

It seems that Vegas does not have enough primary doctors and people has to use concierge doctor.

Concierge medicine is probably the way of the future all across the USA. The overall health care system in the US is broken and it is difficult to forecast the future. One possible scenario of the future is you have your choice of Concierge Doctors or "Public Option" doctors who are government employees and will offer the about the same quality & wait times as the VA.

[Cold Warrior]

Originally Posted by RationalExpectations

Concierge medicine is probably the way of the future all across the USA. The overall health care system in the US is broken and it is difficult to forecast the future. One possible scenario of the future is you have your choice of Concierge Doctors or "Public Option" doctors who are government employees and will offer the about the same quality & wait times as the VA.

Concierge medicine is a relic of the past. Doctor house calls all but disappeared in the 1960s. Why?

Jay Parkinson, MD, founder of the extremely innovative Sherpaa medical service claimed: “There's a reason why house calls went out of fashion. Grossly inefficient use of very expensive doctor time + extremely limited capability.”

[Mike from back east]

Whether the OP returns or not, this is an excellent thread for thousands of people trying to figger out where to retire.

[RationalExpectations]

Originally Posted by Cold Warrior

Concierge medicine is a relic of the past. Doctor house calls all but disappeared in the 1960s. Why?

I'm not a physician, nor am I involved in health care. That is, my musings do not directly reflect any first-hand knowledge, and thus I readily defer to anyone who knows better.

I don't think of house calls when I think of concierge medicine. I think of physicians who, for a fee, limit their practice to XX number of patients, thereby telling members (patients) of their concierge practice they can be seen day-of-telephone-call or at worst next-day.

I contrast that with the current scenario where I've been told there is a 3+ month wait time for an appointment. That is, I ask for the first available appointment, and I'm told that the very first available appointment is 3+ months from today. "But it is urgent!" I protest. "Go to the ER," they reply. "Can you put me on a wait list for cancellations?" I ask. "Sure, but there are already 63 patients on the wait list, so don't hold your breath."

So, to get timely access to a physician, I join their "concierge practice" for a fee of several thousand dollars. Let's say it is $5K per year - and of course that is not covered by any insurance. If the doctor limits his practice to, say, 200 patients, each at $5K/year, that's $1,000,000 up front to fund the practice in lieu of seeing many, many more patients each day.

That works for me. I'd rather pay $5K (I've heard of membership fees ranging from about $2,000 to $7,000 per year) so I have access to my doctor than pay zero and wait 3+ months for an appointment.

That's why I suspect Concierge Medicine is part of the future - but of course there will be no house calls.

[Cold Warrior]

Originally Posted by RationalExpectations

I'm not a physician, nor am I involved in health care. That is, my musings do not directly reflect any first-hand knowledge, and thus I readily defer to anyone who knows better.

I don't think of house calls when I think of concierge medicine. I think of physicians who, for a fee, limit their practice to XX number of patients, thereby telling members (patients) of their concierge practice they can be seen day-of-telephone-call or at worst next-day.

I contrast that with the current scenario where I've been told there is a 3+ month wait time for an appointment. That is, I ask for the first available appointment, and I'm told that the very first available appointment is 3+ months from today. "But it is urgent!" I protest. "Go to the ER," they reply. "Can you put me on a wait list for cancellations?" I ask. "Sure, but there are already 63 patients on the wait list, so don't hold your breath."

So, to get timely access to a physician, I join their "concierge practice" for a fee of several thousand dollars. Let's say it is $5K per year - and of course that is not covered by any insurance. If the doctor limits his practice to, say, 200 patients, each at $5K/year, that's $1,000,000 up front to fund the practice in lieu of seeing many, many more patients each day.

That works for me. I'd rather pay $5K (I've heard of membership fees ranging from about $2,000 to $7,000 per year) so I have access to my doctor than pay zero and wait 3+ months for an appointment.

That's why I suspect Concierge Medicine is part of the future - but of course there will be no house calls.

I see your point now, but is that $5K per year plus a fee for each appointment?

[RationalExpectations]

Originally Posted by Cold Warrior

I see your point now, but is that $5K per year plus a fee for each appointment?

Currently, I am not a member of a concierge practice, so I don't know first hand. I believe there is a normal fee for each visit that is then sent through to insurance. Part of the pitch is the visit is an extended visit - you don't feel like you've been rushed. It is the every-year fee that doesn't go to the insurance companies.

Perhaps someone with first hand knowledge can clarify with their own experiences.

I don't know about how Medicare fits in - Medicare's low reimbursement rates don't seem to be consistent with Concierge Medicine.

[xofruitcake]

Originally Posted by Cold Warrior

What healthcare problem? It does not take much of a search to find these data.

Can you give me a hand? When I did my search, a lot of complaint about long wait, cost of concierge doctor, lack of access to specialized machine like MRI. And then there are complaints against individual hospitals. Yelp Reviewers put sunrise trauma center at 2 1/2 stars, divinity health at 3 stars, southern hills at 3 1/2 stars, Mountain View, desert spring and valley hospital at 2 1.2 stars. There are 4 that are above 4 stars: Elite medical center, center for AMHP, e7 health, p3 medical group..wife has high blood pressure and diabetes and had a silence stroke before...so good medical attention is a must.

[longviewJoe]

There are several concierge docs in LV if you google it. The websites do a good job of summarizing it though none that I see indicate the cost for the membership fee.

[Code Stemi]

Originally Posted by xofruitcake

Can you give me a hand? When I did my search, a lot of complaint about long wait, cost of concierge doctor, lack of access to specialized machine like MRI. And then there are complaints against individual hospitals. Yelp Reviewers put sunrise trauma center at 2 1/2 stars, divinity health at 3 stars, southern hills at 3 1/2 stars, Mountain View, desert spring and valley hospital at 2 1.2 stars. There are 4 that are above 4 stars: Elite medical center, center for AMHP, e7 health, p3 medical group..wife has high blood pressure and diabetes and had a silence stroke before...so good medical attention is a must.

Healthcare here isn't horrible, but there are definitely cities with more aggressive, robust healthcare. As someone who has worked locally as a nurse in Vegas for quite some time, I would not move here expecting great healthcare. Just being honest.

[JonathanLB]

I am interested in the concierge option when I'm older, I mean maybe not that much older even, but in a 5-7 year horizon. I never go to the doctor, just haven't really had the need, but I want to make sure I have a trusted person when the time comes and the cost is worthwhile for my health.

I do think Rational makes a good point, because the simple reality is there aren't enough doctors and nurses to treat the populace. I don't know why this fact gets ignored, as it's readily apparent in countries like Canada. You can certainly raise taxes and you can certainly give "free healthcare to all" and on the face of it, I'm sure to people who struggle to pay their bills, that's a fantastic idea, a dream come true. But none of that dream will change the reality that we simply don't have enough doctors. Now, if we were to combine that idea with perhaps finding a way to educate more doctors, by forgiving their student loans or something like that, by importing doctors from other countries (screw those countries, right?! lol), etc. we might be able to find some way to make it happen. Though I worry what you're actually going to get is a MUCH larger deficit between the rich and everyone else. People like me will have no problem at all paying the best and brightest doctor his / her concierge fee every year, because to me even $10,000/year for my health is really not a big deal, it's an annoyance, an expense, but it's not going to affect my lifestyle. To most of the middle class, that is ridiculous, there's no way they could justify that kind of money on top of other medical bills or expenses. So then instead of 70% of the population getting really good healthcare and maybe 30% getting little to no healthcare, you're going to have 95% of the population getting mediocre-to-poor healthcare and 5% getting fantastic healthcare. You will basically lump the middle class in with the poor and create a two-tier system where there's the rich and everyone else. I don't think the unintended consequences there have been fully understood. There's even the fact that wealthy people can just take a plane elsewhere and get procedures done if they have the money, whereas medical tourism is less of an option for anyone but the top 5-10%.