So today I had my annual physical with my doctor. This is a doctor who has joined a network called Privia Health. While he still accepts insurance, to be guaranteed appointments with him instead of his nurse practitioner or PA, I would have to join. The fee is only $25 per month, so I signed up because I like the doctor.
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The doctor explained to me that he was once in practice where all the doctors went the concierge practice route. He told me that the doctors charge their patients a flat $1800-$2000 per year, demand it upfront, and don't take insurance. In a wealthy area where I live they can find patients to do that.
He told me that the business model requires that they get 600 or so patients. I guess that, if you multiply it, 600*$2000=$1,200,000. When you subtract the cost of paying a receptionist, office rent, and other fees, it probably still leaves them with around $900K or so per year. So I guess that those doctors can live pretty well.
He told me that the advantage for them is that they don't have to work long hours. They can play golf in the middle of the afternoon. But my doctor said he didn't want to go fully that way because it would cut off many of his patients. This way allows patients of modest means to see him still, while also allowing him to earn a better living.
But this trend kind of troubles me. I am lucky that I can afford the higher-tier health system for the most part, though I couldn't afford a concierge practice. But what does it say if insurance won't help you any more because doctors just won't take it? Or what does it say when we have a two-tiered system? I guess, if you're rich, $1800 per year for a doctor who will be at your call isn't too bad. But most of us can't afford that.
From a doctor's perspective, if he wants regular hours and doesn't want to deal with poor people, I guess it works well. But this model doesn't seem to serve most people well.
Has anyone encountered this?