A little story from the emergency room does a great job describing the factors that ended in an unsatisfied customer in the waiting room. Everyone plays into the system:
Not only are there not enough doctors to go around, especially in primary care, but we have an aging and incredibly sick population already making huge demands on our very finite medical capacity. Compounding the problem are diminishing reimbursements to physicians, madcap and increasingly byzantine bureaucracy, a predatory legal environment, and the resulting complete lack of common sense that makes it increasingly impossible for physicians to adequately treat the patients they see now let alone the marauding horde of aging baby boomers about to despoil such capacity as we currently maintain.Dr. Bear's solution is one of concierge medicine, but that could open up a whole other can of worms. Much of primary care is not done right, so scarce resources are spent for naught. If it is done right, someone will have to pay up, but are there enough concierge physicians to go around? But I cannot disagree with the basic premise:
If your doctor only gets a pittance to see you, he needs to see a lot of patients to make a living leaving less time for each one. He’s not a bad guy but he has the same financial pressures on him as you once had before you retired and if you knew how little Medicare reimbursed him for his time, you could easily do the math and see that he’s not exactly as filthy rich as you imagine him to be.
But I can make one suggestion for the folks running Panda's ER: Put the coffee machine away from where patients can see.
3 comments:
Lawrence Brownlee, MD. Tustin, Orange County, California started a concierge practice at the request of some of his patients. All is well after 3 years.
http://www.mdelite.com
How does it help support primary care, or does it potentially harm the population's overall access to primary care?
I have heard arguments either way.
The elite can always take care of themselves, but I work at the other end of the socio-economic spectrum. If concierge medicine makes it even harder for me to recruit, I will not support it.
I see the advantages and the potential harm.My mind is not made up.
Here is a practice that uses its "concierge" side to fund its care of uninsured patients. Each Benefactor pays a fee which is partially tax-deductible and gets concierge style care. They subsidize the care for those in the patient panel who can't pay (or can't pay much).
www.stlukesfp.org
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