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New Medical Practice Models Create Opportunities for Women Physicians!

Going Out On Your Own? Try Concierge Medicine

AAPP boutique medicineLife after residency used to mean hanging out a shingle and opening a practice.  Many of us are told that this is no longer a viable option.   We hear, “The future is in large accountable care organizations and large medical groups.”  But that is not necessarily not true.  Increasing numbers of innovative, entrepreneurial physicians are creating a new reality that is based on a simpler and perhaps more rewarding model of medical practice.  Medical practice that is based on the unique patient-physician relationship.

It’s a growing trend with a new name:  concierge medicine.   This model is also known as boutique medicine, direct-pay medicine, retainer-based medicine, and innovative medical practice design.  This not-so-new model gives the patient direct access to the physician without going through a third party payer, layers of administration, and “physician-extenders.” 

How does this work for patients?  Hopefully better than the system that many patients now complain about.  Greater access, continuity of care, convenient times and locations.  A call back from the doctor and someone on the other line who knows them well–not a nurse, not an assistant, but the doctor in whom they have put their trust and with whom they have a relationship. It seems that some physicians have heard their concerns and created a new type of medical practice.

The particulars of each physician’s situation may differ, but essentially the patient pays for enhanced services.  Usually this is in the form of a yearly retainer and then a fee for services rendered for whatever is not in the retainer agreement.  It’s a good deal.  And ideal deal.  If the patient can afford it.

How does this work for physicians?  It’s the most personalized medical model there is currently and it gives the physician ultimate control over her practice.  Currently internists, family practitioners and pediatricians offer this service as it is not likely to be applicable to physicians who depend heavily on referrals.

The patient population is more affluent, likely more responsible for their own health care, may be better educated and most certainly more demanding of the physician’s time and availability.  A real plus is that insurance carriers are not in the examination room, and neither is the government.  Paper work and a large staff to manage are gone.

Since the time needed for patients is more predictable, an hour visit is usual, flexibility in scheduling becomes easier.  Overhead expenses and volume of patients are low, a good way to keep from being overwhelmed,  but control of “off-time” may become a problem.  Being on call 24/7/365 for a demanding group of patients can be stressful.  Signing out for vacations or unexpected illnesses or family emergencies may be difficult.

One other issue that comes up with this type of practice model is the issue is the ethical dilemmas doctors face when they pledge to care for the poor and give back to the community.  Many women physicians in a concierge practice donate time to other endeavors such as research, teaching, free clinics, political action and patient advocacy.  They sit on the boards of charitable organizations or on the parent-teacher committees at their schools.

Physicians practicing in this model have organized into the American Academy of Private Physicians.  Visit their website and learn more about another way women physicians can find success and happiness in caring for patients.

2 Notes

  1. Here is a really good (and short) video about private pay doctors and how it is good for your patients pocketbooks and access to you, the doctor


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