The other day, we got a letter in the mail from our old doctor in DC. (As an aside, I have no idea how he got our mailing address and it is driving me a little crazy trying to figure it out.)
ANYWAY, apparently this doctor is switching to membership-based care through some third-party company? Since we aren't his patients anymore I didn't read THAT closely, but he seems to have formed some sort of partnership with a third-party company that provides software solutions to allow patients to email the doctor directly, etc. Apparently, this system will allow him to provide a better standard of care without working quite such long hours.
All good and well, right? Except apparently to become a "member" you have to pay a modest monthly fee. And by "modest" he means $45 a month, IF you act fast and become a "charter member."
So, that's $540 per year, per person, for the privilege of being able to continue to see your doctor. It doesn't include the actual health care, or co-pays, that you pay for. It's basically an annual fee to keep the doctor on retainer. AND the fee will go up if you don't join right away. And the price is only guaranteed for two years and I assume that after that it will increase just like every other health care cost.
ALSO, the letter that he sent out, which to be fair he did not draft (it was from the membership software company) but which he still clearly approved and disseminated, said something about, "With the increasing threat of government-run health care..." and OH did that piss me off. I mean, I understand that not everyone supports health care reform (though I would think most doctors would as they don't like being beholden to the insurance companies' whims any more than the rest of us).
But why do you have to get political in your letter that's ALREADY informing your patients that you're about to demand MORE of their money? Why do you have to say anything at all? There's a time and a place, you know? And the last thing I want to hear when I find out that my doctor is demanding many hundreds more of my dollars is that I also disagree with his politics.
My point is, here's another reason I'm glad we don't live in DC anymore. Because we liked this guy a lot, as a doctor and as a person, but if we were still living there, after this, we'd have to change doctors.
So, is this membership thing for doctors becoming a more common phenomenon? Have any of YOU been asked to "join" your doctor's office for the privilege of continuing to receive medical care from them?
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I'm a health reporter and did a story about this trend earlier this year. Primary docs' insurance reimbursements are very low, compared to other docs', because of the way our health system is set up. So, some are switching to so-called concierge practices where patients pay extra to have special attn from the doc.
ReplyDeleteI don't like concierge practices, however, I think they're a direct result of our current -- broken -- system. And that makes the political statement in that letter all the more irritating, in my opinion.
I have not received anything like this and I certainly would not be participating in it.
ReplyDeleteWhat Shelly said.
ReplyDeleteI did hear a news story about a clinic in Washington state (I believe) where you pay a monthly fee, but they they do all of your basic care without any additional charge - all checkups, some basic lab work, etc. It is a good option for people who can't afford or can't get health insurance. But obviously it's different than what your previous Dr is doing. I actually LIKE the idea of the place in WA.
I would never pay for the privilege of continuing to see a doctor. I'd be finding a new doctor ASAP. Glad you moved and had to do that on your own!!!
ReplyDeleteWe have a Concierge Medicine practice here at work.
ReplyDeleteThe way ours works is that you pay the annual fee, but for that money you are entitled to a certain amount of preventive care, annual labs, immunizations, etc. Also, you have 24/7 access to your doctor via email and also HE MAKES HOUSECALLS.
So, for a specialized audience, I think it can be worth the money.
But yeah, in your case it just sounds like paying a fee to keep your doctor around, which: no.
I have a coworker whose doctor was going to do that but I think enough of his patients gave him crap about it so he didn't. Most of these doctors though will offer home visits, which would be amazing and would go back to the true sense of a family doctor. but, if they're just going to charge for them to keep seeing you, that's ridiculous.
ReplyDeleteThey might have sent the letter to your old place of residence and then been informed by USPS about the change.
OH hell no I would not stay with that doctor. The whole idea kind of icks me out. Plus if my doctor got all political in his letter to me, I would probably not be able to resist getting all political in a letter to him telling him I was switching doctors and why.
ReplyDeleteI've never heard of it, but I would not be participating.
ReplyDeletebut wait, he charges a fee if you want to go to him in general, or just the specialty/additional services that you aren't getting right now anyway, like email privileges?
ReplyDeleteThat is astonishing and upsetting.
ReplyDeleteMy husband's primary care doc sent a very similar letter several years ago (way before the election/reform effort began in earnest). We hightailed it out of that practice and found ourselves another provider.
ReplyDeleteDoesn't sound like it's too common, though. Yet.
Re: your address, if you changed it through the post office that makes it accessible to lots of companies, or even just having given your employer and insurance company your new address could have easily filtered down to your previous doctor.
ReplyDeleteIt does seem extremely odd to blame his move to this paid service on the threat of government health care. I guess that means he's not serving any Medicare patients, hmm? But I work for a government subcontractor to find Medicare fraud, waste, and abuse, and so I have a monthly debrief of all the updates and revisions to Medicare billing requirements, and let me tell you: it's ridiculously convaluted, beuracratic, confusing, unclear, and in a lot of ways seems like it's trying to prevent doctors from getting paid quickly and efficiently, so even though I support healthcare reform 100%, I can see how from the perspective of a physician in private practice it could seem like a very ominous thing that the government could be controling more of your cash flow. I don't know whether it's better or worse from the private insurance side, but I do think doctors get paid more for the same things when it's under private insurance, at least currently, so yeah. It's basically all just a huge clusterfuck of crappiness. The way we make people into doctors actually needs to change just as much as insurance needs to change, because when a doctor has to go hundreds of thousands of dollars in debt in med school, he also needs to make that money back in his career, so if we're going to make healthcare cheaper, we need to make drugs, and research, and med school, and a whole slew of things cheaper. When people say "the system is broken," I think they often don't even realize how deep the broken-ness really goes. Ya know?
Like, in the UK, you just go to Uni (which is essentially free) for 6ish years, and then you're a doctor, albeit a very supervised one. And you don't make nearly as much money as a US doctor, but that's OK because you aren't under a huge pile of crippling debt, and plus you are pretty much guaranteed a job. And US people complain that a doctor like that isn't as experienced so their care would be compromised, but you know what? The UK has a longer life expectancy than the US. And a lower infant mortality rate. So obviously something is working better than what we do. Not to say their system is perfect, but still: you've gotta acknowledge the results! Americans just have to realize that we're not the best at everything.
The monthly fee thing does sound a bit rubbish but I love the idea of having a doctor who's on e-mail. And if there was a service that offered internet access to test results so I didn't have to chase up for them, I admit I'd be interested.
ReplyDeleteNot that I would ever pay for healthcare because I get it for free and what I get is very good
(I live in the UK). State-run healthcare ain't so bad!
Political Rant of the Day:
ReplyDeleteSeeing a DOCTOR, getting MEDICINE, and having access to the tools and supplies that will keep you HEALTHY AND ALIVE should be basic human RIGHTS.
A parent should not have to choose between putting food on the table and getting health care for their family.
Visiting a doctor, a healer, should be free, let alone charging extra for membership. This isn't a book club, it's a doctor's office. People NEED to see doctors, they don't NEED to be in book clubs.
This is just another example of how society is pumping up the rich and isolating the poor. Oh, can't afford to join a doctors membership? Sucks for you!
Where is Robin Hood when we need him?
this is to Jersey: those doctors' educations cost more than any of us make. So, when we start subsidizing their education, maybe our health costs will go down.
ReplyDeleteTo Anonymous 2:18 and Jersey: I think you're both right. And I think the comment from PeaceLoveMath shows many of the levels on which our system needs to be fixed. But I think it's pretty clear that the whole thing is seriously flawed as it stands right now.
ReplyDeleteseriously flawed is right - there was a fantastic This American Life piece on the subject of how messed up every piece of the puzzle is at this point, along with how it evolved into what it is. i feel like it's going to get worse before it gets better, but something's gotta give, right?
ReplyDeletefunny, my gp growing up allowed us to email him directly basically right from when email became commonplace. no extra charge... didn't value that privilege nearly enough, it seems!
My boss recommended her doctor to me when I wasn't feeling well. I went once, and last year received the same type of letter basically asking me to pay a subscription fee for her services on top of copays, etc. It was ridiculous. I guess I will be finding a new doctor when I need one.
ReplyDeleteThe effing radio station that I listen to on my morning drive gets all up in my face about health care and I am like STFU!!! For one I disagree, but even if I did agree I just don't need to hear it from my morning radio show guy you know? Just stick to being funny.
ReplyDeleteThis makes me ever so glad to be Canadian!
ReplyDeleteOh Canada, my home and native land. Today I went to meet a new doctor for myself. Booked my annual physical for January. I don't have to touch my wallet unless I need a prescription (and even then, it's covered up to a certain amount by my Ontario Health Insurance Plan).
ReplyDeleteOur Government health care IS MY GREAT LOVE. I'm a hypochondriac, and having to PAY just for an appointment out of my pocket (especially while I'm unemployed) would make me cry. (Our dental is NOT covered by our government, so I haven't been to see my dentist since losing my father's plan after I graduated university, and I won't be back to the dentist until I have a work benefits plan again, lol).
My doctor is okay, but I would leave the practice in a New York minute if they pulled something like that, even without the politics sprinkled on top. Ugh!
ReplyDeleteI did get a confusing letter from my GYN a year or two ago. I glanced at it and thought he was retiring, then read it more closely and found he was retiring from the OB part, but still doing what I need. So not a problem for me, but we do skim doctor letters, don't we?
Fuck that (please excuse the language, I really am a lady). Yet another reason why we need some major change in our health care system.
ReplyDeleteMy new Dr has a website and email for emailing direct questions. It's free.
ReplyDeleteWow that is crazy. Haven't seen anything like this from my doctor and hope to never see anything like this! Thank goodness you are no longer with that doctor...
ReplyDeleteThis is actually becoming more common than you think and quite honestly your doctor was offering a bargain price! I've heard of doctors around here that charge upwards to $2500 annually for the 'privledge' of having them as your physician. I say horse manure on them!
ReplyDelete