Concierge Healthcare

…or Boutique Medicine or other trendy names for what amounts to the same thing. Paying your Doctor an annual fee of around $1500 on top of what you pay for health insurance.
In return you get (let me check the pamphlet I just got in the mail)

-After hours direct access to your physician by cell phone or pager.
-Same or next day appointments.
-Appointments that start on time and last as long as needed.
-Enhanced coordination of necesssary referrals
-Dispensing of many prescription medications for sick visits in the office.
-Telephone and email consultations.
-Unlimited visits with your physician

I’ve gone through 3 doctors in 5 years and it looks like I’m about to lose my current one as well unless I spend the money to join the new Concierge Healthcare practice he is opening up. I guess the days of having a family doctor who you use for years and years may be gone. This sucks though because I really like my current doctor. Enough so I’m somewhat considering joining.
I’m not sure though if the benefits justify the expense.

Is anybody currently a member of a practice like this. Can you share with me your experiences? Is the service worth it to you or has it been somewhat of a dissapointment?

For reference please include your age and a rough snapshot of your current state of health.
I’m a 29 year old male whose only health problem is pre-hypertension for which I go in every 6 months to get checked out.

Meh, I go to a basic general practicioner who left the doc in a box operation he had been with and opened a private practice. I can get same or next day appointments, he is rarely overbooked and has a kickass good staff including a couple incredible nurses and a rocking PA. He always takes the time to answer questions, I never feel rushed. He takes both my aetna and tricare so it balances out that I never even have a copay. Best of all? He and his staff actually LISTEN. They all understand that when I say something hurts or is going on, that is exactly what is happening. We work on making sure all my meds are known and nothing is going to go wonky. He lined me up with an amazing endocrinologist, and an incredible podiatrist, and an incredible OB/GYN [being all local docs, and knowing each other made it handy]

Of course, I am one of the very few anglo patients he has. He is hispanic, and in located in the hispanic part of New London, and specifically caters to hispanics. I loved finding a doctor who actually opted for GP to serve a community instead of specializing and going for the money. That makes him rock in my book. [he is also mrAru’s doc, and I recommend him to people I know are looking for a doc that are new in the area.]

A thread I started on the very same subject:

It turned out that my doctor, of the 3 in their practice, has not gone the concierge route.


She and I chatted about it and she said that it’s becoming quite difficult to make a decent living as a doctor, without either doing this, or joining one of the megapractices.

Sigh… Here in the US we spend the most on healthcare in the world, and have the worst care overall in the developed world (no cite, but read an article relatively recentlly asserting both of these), and access to primary care is becoming more of an impossibility now even for people with insurance, unless they have the private means to fork over a couple of thousand extra.


I rock up to my local doc unannounced. Sometimes I might wait twenty minutes (max). Usually, I just walk in. I don’t pay anything (and I’m employed, not on welfare). He’s also a good doctor, and I’ve been going to him for many years.

This being the case, as a patient I’d find it hard to justify the expense. Even if you had three visits through the year for acute illnesses on top of your two checkups, you’d be paying an extra $300/visit. For that kind of money my Z-Pak prescription had better come with a car wash and an erotic massage. If I had a lot of chronic illnesses that required frequent visits and hospitalizations and such, it might be worth it if there weren’t any accessible doctors in the area.

As a physician I wouldn’t do this (as you describe it) because it would probably attract every hypochondriac in town. The one thing you’re not supposed to do with hypos is give them unfettered access; you set a schedule and see them on that schedule. I’m sure doctors who go this route expect a lot of patients like you, but there are plenty of patients out there who wouldn’t be worth an extra $1500 if they had no limits at all.

It would also encourage an attitude of “I’m paying you good cash money, so you should give me whatever I want,” which isn’t healthy. In fact, one doctor I know of who calls himself a “boutique practice” (he takes cash only) mostly hands out narcotics, benzodiazepines, and diet pills, and his patients usually go elsewhere if they’re actually sick.

“Give the patient what he wants” is a dangerous idea in medicine. It’s great if it means seeing appointments on time and actually listening; it’s horrible if it means giving out antibiotics for every sniffle and addictive medicines for anyone who asks for them.

Yeah, and I am definitely leaning towards not doing it although I could afford it without too much trouble. If the general consensus was that this is the way that medicine is heading in this country in a few years and I might as well sign up with the Doc I like, I would probably feel differently.

I had thought of this as well. Sure they are taking on 1/4 of the usual amount of patients, but the patients who feel justified in paying the extra expense aren’t the people like me who go in for a quick checkup twice a year. They are the people who expect to need many many appointments during the year. How do I know that it won’t end up taking just as long to schedule an appointment as before?

Thanks for the link! A searched once, but must have not gotten the search terms right.

Nobody here actually ponies up for this service?

Well, maybe that’s part of my answer right there.