One of the great things about concierge medicine (also called direct practice) is the ability to contact your doctor at any time. Also, that your doctor will work with other caregivers and advocate on your behalf.
Yes, it costs you extra for the extra service, but that is how the doctors can reduce their case loads and free up the time to provide you with additional attention. Not everybody thinks the additional fee is worth it, but many do. Plus an argument can be made that the customized care saves money by reducing duplicative tests and hospitalization.
The New York Times now reports that Medicare will try to replicate these benefits. Come January it will pay physicians an extra $42 a month to coordinate the care of patients with two or more chronic conditions. The patients will have to sign a contract with the doctor and will pay 20% of the additional cost.
Now, of course bureaucracies have a way of turning even the best ideas sour. In this case, will the $42 be enough money to allow the physician to reduce their patient load to free up the time to perform the additional services? How was the $42 determined? Plus, it is curious that the only patients eligible are those who already have two or more chronic conditions. Perhaps the best opportunity for intervention is well before patients develop chronic conditions.
And we can expect that Medicare will be so nervous about this new benefit that physicians will end up spending as much time filling out paperwork for the bureaucrats as they do caring for the patient. The Times writes –
As part of the new service, doctors will assess patients’ medical, psychological and social needs; check whether they are taking medications as prescribed; monitor the care provided by other doctors; and make arrangements to ensure a smooth transition when patients move from a hospital to their home or to a nursing home.
You can imagine all the reports that will be required by Medicare to prove the doctor actually did all this.
So, we will see how it works out. Still, Medicare deserves an “atta boy” for recognizing and rewarding the essential role of the personal physician in patient care.