July 6th, 2007 by David E. Williams of the Health business blog
In MDs offer new services, for $3,600 yearly fee, the Boston Globe tells us about a few doctors who are switching to “concierge” practices by ejecting the majority of their patients and charging the rest an annual fee. Their objective is to improve their lifestyles and pay, and provide better service to patients along the way.
I really don’t like the concept, as I’ve written before. My primary care physician and many others like him –driven primarily by a love of what they do and dedication to their patients– work their tails off to provide excellent service to a large number of patients. Some also employ tools to improve workflow so they can achieve more with less.
I prefer things that way, and not just with physicians. I also like working with lawyers, accountants, consultants, engineers and other professionals who love to work like crazy.
I do want to point out something a little bit funky about this article: the number of patients these physicians claim to have. One doctor:
…recently mailed a letter to most of his 5,000 patients asking them to voluntarily switch to another doctor in the practice.
Another duo says they have 7500 patients between them, or 3750 each.
I think these numbers are an exaggeration, especially the first. Most primary care physicians have 1500 to 2500 patients and somehow seem to survive. To have even 3750, never mind 5000 would require never seeing most of them or making heavy use of nurse practitioners and other “physician extenders.”
If these doctors are struggling under such heavy loads, why don’t they just scale back to a typical number of patients rather than going berserk and dropping to only several hundred?
If concierge medicine becomes a serious trend, a lot of non-concierge patients are going to get squeezed. I have an idea about how to deal with that, which involves leveraging primary care resources abroad. I’ll write more on that when I have the chance.