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I only know of one or two physicians in the area offering a concierge practice. However, Utah is not a place where trends begin and take hold.
I really could never understand why anyone would want a concierge physician until I saw some of the struggles my parents had when they got older. They related to me how difficult it was to get some physician services under Medicare, My mother actually had a cardiologist make appointments and than refuse to see her when she came to his office as scheduled. He would pass her notes through an office nurse about her condition and what to do about it. (Yes, that is really a true story) I did wonder if they might benefit from concierge services. However, her primary care physician is wonderful and will spend however long she needs with her even with limited reimbursement.
I don't see the value in concierge services. However, maybe as I get older I will.
I hope that doctor didn't try to bill Medicare for an office visit when he didn't even see your mother.....
What does anybody know about private practice physicians? I know they do not work for, or get paid by, hospitals. Anything else? Thank you.
Many physicians don't work for hospitals ( ie, are not hospital employees), but have their own private practices- hence the term, private practice physicians. These physicians may have admitting privileges to hospitals, meaning that should they believe a patient of theirs needs to be hospitalized for a condition or illness, they can admit the patient to that hospital and supervise their care there. If they do so they still don't work for the hospital and are not paid as an employee of the hospital.
Although it seems these days most of these docs don't supervise any care for their patients who are hospitalized, and don't come to see them while they are there. The patient care is left to hospitalists, physicians ( who may or may not be considered employees of the hospital, depending on the arrangements between them and the hospital- may be contracted to see patients- and/or collect payment from both the hospital and directly bill patients for their services. Or they may be hospital employees, in which case it can be said that they "work for the hospital".
So, that website, is just a listing site, for concierge practices. If you want to find a normal regular MD who has a normal regular private practice, you could try the Yellow Pages under "physicians." Then make some calls and simply ask them if they are a concierge practice, or if they offer traditional services and accept insurance. In fact, many physicians buy ads in the yellow pages, and those ads specify whether or not insurance is accepted.
Edited to add: Until reading about it here on CD, I had no idea that such service as concierge service existed. I don't know of any concierge-service physician in this area, and I don't know anyone who uses any such service. If it exists here in my area, maybe it's just exclusive, like one of those "members only" clubs that most people aren't entitled to even know about, let alone join.
Concierge Doctors are a pretty new concept - it is a result of ObamaCare. I never heard of them before the ACA was passed. While the average American "didn't know what was in the bill" and "didn't read it" - the Physicians and Hospitals certainly know what it does. This is going to be an 'unintended consequence' of ObamaCare ….. Doctors that charge a patient a fee to join their service.
Many doctors have gone the Concierge route to deal with ObamaCare. I'm even looking at a Concierge type Medicare policy that looks like the best deal I can find in my area.
I am very familiar with concierge medicine, had a doctor who switched. He's on call for his patients
24 hours a day. Hefty fee which really is boutique medicine for the wealthy.
Also another new concept of hospitalists. Only a few years ago, most of the doctors my friends and I
had would go to the hospital if their patient was there and that was good since your doctor knew
your history (morning hospital runs). A hospitalist doesn't know a thing about you.
This is a new reality today for patients. My Mom was recently in the hospital - she had a couple of episodes before she went to the hospital and refused to go after EMT's were called. I got her in to see her Doctor that has treated her for years. He explained to her that she had to demand to be taken to a specific hospital where her doctors could be involved in her treatment. She did that and then we discovered that the Doctor she had used for many years (she is on Medicare) had dissolved all his 'hospital admitting privileges' - she had to use the 'hospitalist', but they did contact her Heart Doctor who retained his hospital privileges.
It's a whole new world under the new ObamaCare laws - Doctors are looking out for what is going to work for them and their Private Practices. The new "Rules" are so onerous for Doctors that they are figuring out ways to deal with them. Many people will have no idea of this until they end up in the hospital and are suddenly dealing with strangers.
Our recent experience was lucky - the Cardiologist was still an admitting physician. If her problem had not been "heart" related … she would have been on her own with 'stranger doctors' at age 92. It's a rotten situation, but I can't blame the Doctors who wanted no part of this Debacle.
Concierge Doctors are a pretty new concept - it is a result of ObamaCare. I never heard of them before the ACA was passed. While the average American "didn't know what was in the bill" and "didn't read it" - the Physicians and Hospitals certainly know what it does. This is going to be an 'unintended consequence' of ObamaCare ….. Doctors that charge a patient a fee to join their service.
Many doctors have gone the Concierge route to deal with ObamaCare. I'm even looking at a Concierge type Medicare policy that looks like the best deal I can find in my area.
Quote:
Originally Posted by Kibby
It's a whole new world under the new ObamaCare laws - Doctors are looking out for what is going to work for them and their Private Practices. The new "Rules" are so onerous for Doctors that they are figuring out ways to deal with them. Many people will have no idea of this until they end up in the hospital and are suddenly dealing with strangers.
Our recent experience was lucky - the Cardiologist was still an admitting physician. If her problem had not been "heart" related … she would have been on her own with 'stranger doctors' at age 92. It's a rotten situation, but I can't blame the Doctors who wanted no part of this Debacle.
Glad to hear your mother got the care she did from her doctor.
Regarding "Obamacare." It may be true that some doctors chose the concierge route however, I have a
specialist who went concierge way before that. Now, he is a great specialist and he was kind enough to
give me a scholarship. However, I currently live too far to drive and see him only once a year.
btw, he was all for the ACA. He chose to become concierge since he is now teaching at a major
hospital and traveling around the world lecturing about his field of expertise. I don't know how he
manages to do concierge when he's traveling since that type of practice allows patients to call him
at any time and includes daily visits to any patient who is in the hospital.
Oh! Well if that's the case, you're talking about what we used to call "the doctor that works at the hospital" vs. "our own private physician."
Yeah my regular physician doesn't practice any kind of medicine that would give her any reason to work at a hospital. And so - I'd never use her for inpatient stuff. She's just a normal regular doctor - used to be called a GP - General Practitioner.
My orthopedist does orthopedic surgery - both in, and out, of the hospital, depending on the medical need of the patient. If the patient needs to be kept overnight or for several hours, then they go to the hospital. If it's an outpatient surgery - it's done at the surgicenter.
I wouldn't use a hospitalist for orthopedic surgery, I'd use my orthopedist, who is not a hospitalist, although he does have days when he does surgery at the hospital. Same with my ob/gyn. But if I was brought into the emergency room and then admitted, I'd use whatever doctor was there to treat whatever the problem was. I don't think I'd be very picky, in an urgent situation. If it's not an urgent situation, I'd be going to a specialist that has both hospital privileges -and- office hours in a normal office so that I didn't have to go to the hospital for follow-up appointments.
In the olden days, e.g. prior to hospitalists, about the only docs who worked directly for a hospital were ER doctors. Yes, hospitals own some medical practices, but that's not quite the same thing. This doctor in bold did not exist.
Quote:
Originally Posted by AnonChick
bluedevilz, I'm trying to say that I don't know of ANY specialist who works in a hospital, who doesn't also have a private practice/group practice outside the hospital. I think the idea of a specialist who works exclusively in a hospital, and nowhere else, to be bizarre. The concept is totally foreign to me, and so defining a word, to someone who has no experience of the concept, isn't helpful.
What you think of "working" in a hospital is not the same as being paid by the hospital for one's labor. A doctor who does surgery at a hospital, but maintains his/her private office is not working for the hospital, s/he has "hospital privileges". In other words, s/he can admit patients to the hospital and use their facilities.
Quote:
Originally Posted by Ruth4Truth
I know a few private practice non-hospital affiliated, non-insurance docs. Some are outstanding doctors, the best! They actually listen to their patients and take their concerns seriously, think outside the box when faced with difficult or unusual cases, and usually charge an arm and a leg, but they'll fix what ails you. The reason they don't accept insurance is that insurance limits the types of tests they can order, so they wouldn't be able to get to the root cause of an ailment and treat it and monitor treatment if they accepted insurance. Insurance is too constraining.
Another reason some don't take insurance is because insurance may not pay for some "offbeat" things they do. For example, some pediatricians who only give one immunization at a time, and have patients coming back monthly to get infant immunizations, charging a fee each time, run "cash only" practices. Insurance wouldn't pay for that. "Thinking outside the box" can include some strange stuff.
Quote:
Originally Posted by baileyvpotter
Just out of curiosity, before this fairly new method of hospitalists - let's say you thought your appendix ruptured and
went to the hospital during the weekend....what did they do once you were moved out of the ER and surgery was
needed?
ER docs usually don't work for the hospital. Sometimes they do, but they are in the minority. They are private practice docs too. They form a group, and their group has a contract with the hospital to provide ER services. The group bills the insurance company, and that is how they get paid. If you have ever gone to the ER, you probably have gotten a bill in the mail for the balance of your treatment that insurance didn't pay. That bill is from the ER Doctor group, not the hospital. At least in most cases. Some hospitals (a minority, but growing) hire ER docs as employees, and the hospital takes care of all the billing and office work.
The same goes for other hospital based physicians, including Radiologists, Pathologists, and Anesthesiologists. My private practice group has contracts with hospitals and surgery centers. The hospitals don't pay us, the insurance companies do. Some of the hospitals pay us a stipend to take calls there, which is only fair because we are required to stay in house, whether there is work for us to do or not. We have offices in the facilities, but we also have a central office that is not in a hospital.
It seems to me that all the debating and disagreeing going on here just proves my original point - the medical world has changed drastically and no one is explaining it to the patient. They are all just saying "do this; do that" or not saying anything at all.
I keep remembering my long-ago and still favorite doctor. When I went to ER and they called him, he showed up within the hour. When he found I needed an appendectomy, he made some calls and returned to tell me who the surgeon would be. He explained that the surgeon would be my "primary care doctor" while I was in hospital. The two doctors consulted with each other about what was being done and both doctors visited me daily, keeping me informed. The surgeon did all the ordering, of course, but there was open communication between them and with me. One day, when the surgeon was going to be away, he explained the day before who would be replacing him for that day and what I should expect. No surprises ever.
The lights were bright all over the world back then. It is terribly dark now.
Well right there you pretty much hit the nail on the head. I've been an internist since 1979. When we docs began to drift away from the hospital, the patients generally found out on their own. And at life's worse time. A real tragedy IMO. I was the last local primary care doc to give up the hospital, by about 2 years. Already about a third of my patients were getting admitted without me knowing, due to hospital and ER ineptness. And what finally drove me away about a year ago was the hospital's electronic medical record. A horrendous abortion where each time you had to log on 4X, with a different password for the 4th log on! That last straw broke my back. Now I rarely know if any of my patients get admitted, unless they set up a post-hospital visit.
From what most primary docs now do today, IMO we can easily be replaced by a mid level provider, a cheaper PA or NP.
This is a new reality today for patients. My Mom was recently in the hospital - she had a couple of episodes before she went to the hospital and refused to go after EMT's were called. I got her in to see her Doctor that has treated her for years. He explained to her that she had to demand to be taken to a specific hospital where her doctors could be involved in her treatment. She did that and then we discovered that the Doctor she had used for many years (she is on Medicare) had dissolved all his 'hospital admitting privileges' - she had to use the 'hospitalist', but they did contact her Heart Doctor who retained his hospital privileges.
It's a whole new world under the new ObamaCare laws - Doctors are looking out for what is going to work for them and their Private Practices. The new "Rules" are so onerous for Doctors that they are figuring out ways to deal with them. Many people will have no idea of this until they end up in the hospital and are suddenly dealing with strangers.
Our recent experience was lucky - the Cardiologist was still an admitting physician. If her problem had not been "heart" related … she would have been on her own with 'stranger doctors' at age 92. It's a rotten situation, but I can't blame the Doctors who wanted no part of this Debacle.
This has been done and over since before Obamacare. Most all primary care docs I know gave up their privileges 5-10 years ago. Most medical specialist still have inpatient privileges.
Concierge Doctors are a pretty new concept - it is a result of ObamaCare. I never heard of them before the ACA was passed. While the average American "didn't know what was in the bill" and "didn't read it" - the Physicians and Hospitals certainly know what it does. This is going to be an 'unintended consequence' of ObamaCare ….. Doctors that charge a patient a fee to join their service.
Many doctors have gone the Concierge route to deal with ObamaCare. I'm even looking at a Concierge type Medicare policy that looks like the best deal I can find in my area.
No no. Concierge has been going on more than 10 years. Concierge can only support a few primary care docs, and only in larger and affluent big city areas. I care for about 500 Medicare patients at any one time, and very few can afford anything like Concierge.
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