It was recommended that I change my title because people thought it was about the election.
I don’t know if I can keep hanging out with you guys. I might just be too damn cool. It’s surprising because I never thought I would be the kind of person who gets high and mighty after they are asked to join an exclusive club, but now that it’s happened to me, I’m not so sure. I have to admit I’m giving some serious thought to cutting some of the little people loose. Curious about the club? Join me after the jump.
Yesterday I received an envelope containing several creamy white pieces of fine linen stationery. On the pages were tantalizing words about a club so exclusive its membership is limited to 400 people. Let me just emphasize here (mostly for myself) that I am one of the chosen people who could potentially rub shoulders with 399 other shiny happy people who may accept this invitation. What club is it you ask? Why it’s none other than my doctor of over twenty years. Yes, this Board Certified Internist who knows me warts and all (literally) has decided to change her business model from Doctor’s Office (yawn) to what is known as a Boutique Medical Practice. Her letter doesn’t use the term Boutique, but I’m a sophisticated consumer and I can read between the lines. I know that even something as boring as a stethoscope looks gorgeous covered in Swarovski crystals, which is what I imagine a stethoscope in a Boutique Medical Practice will look like. Hmmmm - I bet I’ll get my choice of chamomile or Darjeeling tea while I sit in the cushy chairs of the new waiting room, but I digress.
An excerpt from my brush off, I mean my invitation:
"Despite my best efforts, I am not able to continue this level of care under my current practice model. Therefore, effective Wednesday, January 2, 2008, I am establishing a membership practice which will be limited to 400 patients. This new practice is based on some excellent and innovative ones that select physicians across the country have adopted in order to deliver the kind of care and service their patients need and deserve."
Gee – if I wasn’t so impressed with myself and my new club, I might feel a little abandoned, lost, dare I say - bereft. I might think the letter sounds a little like one of those conversations where someone breaks up with you and says "it’s not you, it’s me." Hey wait a minute – I just got dumped by my doctor. Dumped that is, unless I am willing to open my wallet.
I know I’m not the only one this is happening to. For starters, my doctor currently has over 2000 patients who are also getting the beautifully styled Dear John letter. People all over the country are getting these letters because the doctors are fed up with the teeming masses of sick people coming through their doors carrying little plastic cards with all kinds of logos, in network, out of network, Medicare, private insurance, private administrator, TPA, yes co-pay, no co-pay, I forgot my checkbook, I’m out of work and can’t ever pay you. What the hell is happening and what the hell are we going to do? Now, even having a Blues healthcare plan isn’t good enough anymore.
Let me say that I am one of the lucky ones and I know it. I have insurance and have been fortunate enough to follow a physician long enough to have an established history. I know there are a couple hundred thousand people who don’t get to see a doctor at all let alone get invited to some country club medical practice.
The price for the many perks that come with this membership (more on those in a minute) is $1,800 per year per patient. There is a $50 discount if I let my husband join with me. I’m still deciding on him – not sure if he will be able to truly appreciate the finery of this kind of medical practice.
Clearly, my doc knew there were going to be a lot of questions, so she answered them in an orderly fashion in her announcement. Her answer to the question – "I have good health insurance, doesn’t that pay for this already?"
"Your health insurance generally pays for you to come in for a 15 minute visit to address health problems that are covered. It does not pay for any enhanced services or conveniences that I plan to offer."
Tell me more baby...
"I provided many of these services as much as possible in the past, but cannot do so any longer. For these services to be covered under most insurances you need to physically come in for an appointment. That means taking time off from work, arranging for child care, etc. My patients have told me this is not the kind of service they want and need. Often a quick phone call can alleviate worry about a test result ordered by me or a specialist. Serious problems need to be diagnosed and treated quickly, not when there is an opening in the schedule."
So for nearly two grand a year, my doc will reassure me about my cholesterol results over the phone. Other member benefits include:
Personal coordination of care with specialists, including assistance with scheduling of tests and consult appointments.
Thank you for putting in a good word for me with your cronies so I can get an appointment!!! I am not worthy.
Office announcement and reminders e-mailed to me (such as flu vaccnine available and physician’s vacation schedule).
Via e-mail, you say? Amazing!
Copies of my test results mailed, faxed or e-mailed to me.
I can’t stand it. My own personal test results!!!!! Sent to me!!!!
Well, after sharing this with you, my friends - my little, little friends, I don’t think I’m so cool after all. I think I know my place. I pay for a portion of my health insurance through my employer and I just don’t have another $2,000 to pay to join this little club. I’m going to be staying right here with the rest of the poor schlubs who are grinding through the gears of this broken health insurance system in the greatest country on earth. I’m apparently in the market for a new doctor. Just your basic run of the mill doctor who will check to make sure I have my referral form and jam me into a double booked schedule with everyone else. I never knew a crystal encrusted stethoscope could feel so cold.