I was repeating what the interviewee said, but I don't really understand what that concierge service might be. If you go see a GP for some ailment that needs further work by more specialized people, doesn't your GP just refer you? What exactly is the value-added of a concierge?
In the case of the uber-rich from the story, if I remember right, it's that by paying the money one could bypass the usual queue and be seen by someone more quickly, and also, in the rich patient case, have a stable of specialists all over the country to choose from. I hope I'm remembering the program accurately.
This implies to me that the better the concierge (bigger the kickback to the doctor that is) then the higher chances of avoiding the queue. Is this system transparent? Do you know beforehand that a $2500 per year concierge can get you in within a week but a $5000 per year concierge can get you in the next day? I am asking that cynically because I can easily see something like that happening, but I'm also serious in wondering how it is all managed. If your appointment is postponed, are you told it's because the doctor got a better offer?
I am somewhat familiar with a concierge medical service. The basic cost (subscription) is $6,000 a year, plus there is a charge per appointment, depending on what is done. (I think they do take insurance and Medicare.) I don't know how many people are enrolled in the service, but I would imagine it's a few hundred -- the doctors (there are two of them) have a limit on how many people they see. They also employ a nurse practitioner who can take care of a lot of routine stuff like shots. If you are actually ill, you can get in same-day, never a problem. If you need routine care, always the same week, often same-day or next-day. Things like physical exams are scheduled. If you need specialist care, you're referred -- but specialists (outside those who operate within a larger clinic or hospital) really operate a kind of concierge service as well. If you're referred, you can usually get in within a couple of days.
I have a friend who subscribes, and he has suggested that I join, and I'm thinking about it. I currently go to a clinic, where I like the doc and his employees, but the waiting room drives me crazy -- I'm old, and the waiting room is always full of school kids with every disease imaginable, plus a lot of sneezing adults. I'm sort of afraid to sit down, and I'd never pick up one of the magazines. Waits can be an hour or more past your appointment time. I'm healthy, hardly ever go to a doctor, but I wanted to resume scuba diving last year, after a long layoff, and I couldn't take the refresher course without getting a doctor's permission. To get that (what amounted to an interview and light physical exam) I had to wait more than a month, because I had no really urgent medical problem.
One of the problems with Medicare is that it drives down prices to save money, but that means that a lot of the clinics are shabby, over-crowded, etc. I also suspect (and I may be totally wrong) that the most qualified docs go into specialties, and the family-style doctors are possibly not the sharpest knives in the dishwasher. My doc is almost as old as I am, and came from old style medicine, where the doctors made a lot of money and things were less pressured. No longer the case. The fact is, we're well into baby-boom old age, and the medical facilities are jammed up with Medicare patients (like me.)
