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Saturday, July 5, 2014

The Doctor Makes House Calls Again, But It Isn’t Cheap

Concierge medicine brought to you by our healthcare crisis
Thirty minutes into my scheduled appointment, I walked up to the receptionist, busily immersed in computer solitaire, and asked how much longer before I saw my doctor. She appeared accustomed to this request and brushed me off with a standard “Just a few more minutes” reply.

Trouble was, I’d allowed myself plenty of time for the doctor and then scheduled a client (to, uh, pay for that specialist visit).

I was ready to reschedule my client when an assistant called me into the back. Once my doctor actually saw me, he hurriedly perused my files and brushed off my request for specific tests. I think I even got a How dare you question a doctor’s authority! stare.

Clearly, my doctor had these things timed: No more than 15 minutes per patient.

When I mentioned I had been having some trouble sleeping, he promptly
reached for his pad mid-sentence and wrote a popular sleeping pill prescription.

Call me cynical, but I’m pretty sure the drug manufacturer courted my doctor’s office with free lunches.

Welcome to modern medicine. Science continues to evolve and yet the medical industry descends into the dark ages.

Here’s the clincher. As angry as we want to be at doctors, it isn’t their fault.

Cutting-Edge Medicine and Backward-Thinking Politics

Maybe your grandparents reminisced about doctor house calls. You probably saw this archaic phenomenon occur on TV or movies.

Today, having a family doctor not only visit but actually listen and care seems like a relic of another era, like having your mail twice-delivered daily.

Even a generation ago, Western medicine felt more civilized. Some readers can remember having a compassionate nurse see you before the doctor stopped by. She would smile and you knew she felt compassion. Even if the doctor seemed a little brusque, nurses and assistants could assuage your nerves.

If I wanted to revel in nostalgia here, I would pull out old photo albums. What I want to do instead is challenge the medical industry to become better. I wouldn’t bother if I didn’t believe it had the potential.

Our Modern Healthcare Crisis

I get sick of hearing the debate too, but we truly are in the midst of a healthcare crisis. Modern medicine has become so needlessly complicated. The body is complex; medicine is complex; as a whole, the medical profession could benefit from becoming simplified.
Let’s say I have a skin issue and want to see my dermatologist. I don’t need my family practitioner to tell me I have a skin issue, so why not just cut through the middleman and go straight to my dermatologist?
Insurance companies, that’s why. Their HMO programs want you to first see your primary care physician, who can then refer you to a specialist. While labor intensive, drains time, and costly for the patient, this benefits insurance companies.
Stopping Blaming Your Doctor
Doctors have become the whipping post for too long. I understand how frustrating waiting forever and then getting maybe 15 minutes with your doctor can be.
Imagine if you met your friend at Starbucks and only talked for 15 minutes. You wouldn’t be able to cover much, right? You’d feel like you wasted your time driving there and back for 15 measly minutes.
It’s not their fault. Overscheduled and chronically stressed, most doctors battle a mountain of restrictions, regulations, and bureaucratic paperwork that sucks away their time.
To compensate, they hire more employees (don’t get me started about undertrained, underpaid receptionists), buy obscenely overpriced malpractice insurance, and live with the treat of salivating trial lawyers waiting in a moat surrounding their offices, all while receiving paltry health insurance reimbursement.
As kids, we thought becoming a doctor would be a highly paid profession.
Think again. After spending 15 years in school, a doctor now makes less money than ever while insurance companies demand they see more patients in less time and money.  Obamacare promised to fix everything, but I’m not holding my breath and neither should you.
Listen, I realize exceptions exist. Some specialists are overpaid; some doctors are unethical or schmooze with pharmaceutical companies; a few medical people are just in it for the money. But overall, it isn’t the doctors who are created modern medicine hell.
I know enough doctors – and enough doctors reading this blog – who struggle with adrenal burnout and other health issues with their over-scheduled, under-valued jobs. Several have said, “Enough 70-hour weeks” and thrown in the towel for more time with their family and less at the office.
Curbside Service… For a Price
During a training session recently, a client made a passing reference to her doctor “stopping by” when she had strep throat. “Wait, you’re friends with your doctor?” I asked.
Nope. My client had a concierge service that provided a full team of medical experts who showed up within short notice to her home. Could it be in our hurried modern age a few doctors are “throwing it back” to earlier times when they actually cared and listened to their patients?
Well, yes and no. Entrepreneurs always look for opportunities, and they’re ripe right now within the healthcare industry when patients feel short-shifted and neglected. Concierge services are simply supply and demand. God bless America.
My client waxed poetic about her concierge service’s many privileges, which included unlimited direct email and phone service with her primary physician. “I swear to you, he will actually stay by my side until all my questions have been answered,” she said.
I wanted that and was sold.
Or was I? “How much do you pay for these services?” I asked, knowing full well my client married a wealthy, much older man a few years ago.
Oh, about $3,000 a month.
Welcome to Los Angeles, where no matter what service you provide, someone can afford it. Someone will buy it. We’re not the porn capital of the world for nothing.
Now, mind you, concierge services encompass a wide range of services and pricing. Do some online sleuthing and you’ll find a wide array of options and prices for doctor services. You can Skype, have unlimited email access, and get a direct 24/7 phone number with a medical doctor; all have their price.
I’ve had enough frustrating experiences with my doctors that I would definitely consider concierge services. If, you know, I had an extra $50,000 income coming in every year (which I don’t).
Especially if you want to spend more time with your kids and less time at the office, becoming a concierge doctor makes sense. Hell, I even considered for a second going back to medical school just to become a concierge. I love the idea.
Otherwise, the medical profession’s future looks pretty grim. College kids, listen up. If you want to make money in medicine, become a concierge doctor or sell your soul to an insurance company.
Everything old is new again. Except this time around when the doctor makes a house call, you better have the money to pay for it.
Your turn: Can you remember a time when your family doctor called to remind you about yearly physicals and everyone knew you by name? Share your thoughts and stories below or on my Facebook fan page.
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