http://www.msnbc.msn.com/id/34019606...h-health_care/

Discuss, do you guys think this is right? I mean aren't poor people in this nation be able to get good health care too? Such a sad state of affairs we are living in right now.

Our clinic has looked into going this route. You work less and make more money (at least, that's the idea.) But in reality, it's tough finding people who will fork out this kind of cash in a small town. Most of the Drs I've seen go this route were in the bigger cities.

Good for these doctors.

They have spent their lives gaining a skill which they have the right to value at any price they want.

If you don't think they are worth the price they are asking then you have the right to take your business elsewhere.

If poor people want to be able to access a doctor who monetarily values his skill above the average doctor then the poor person needs to do something to get the necessary money to pay for the access. If they cannot, then there are other options available.

 

Originally Posted by ace bentley

You are spot on except for this. It really has nothing to do with skill level...more like sales. If you can talk 250 patients into paying you $2k a year each, you make half a mil without being very busy. They aren't putting a value on their skill, more so on their time.

There isnt any difference.

 

Originally Posted by ace bentley

I disagree. The best surgeons in the world can charge whatever they want because people with money will pay for it. On the other hand, just being a surgeon doesn't mean you can charge the same. There's not a flat rate based on skill level. When we were contemplating this change, we were going to charge $2500-3000 per year per patient. That doesn't mean our physicians have twice the skill level as the doctor in the article, rather they want to see less patients and have more time off.

You guys were free to value your skill/time @ $2500-3000 if you like. Whether or not the market would agree with your valuation is a different story.

I suppose you are correct that in come cases skill could be irrelevant. But skill is dependant on what price consumers are willing to pay for services. If Surgeon A (who happens to be a world class surgeon) charges and gets X for his services and Surgeon B (who happens to be a rural surgeon) charges and gets X also then the market has dictated that both are equally skilled and both surgeons time are equally valuable.

Btw everyone should vote in that poll on that website and read the comments from the people who disagree with consierge services. They are amazing.

Interesting article in the paper this morning. What do you say OT? Would a program like this be of interest? Obviously this would not get much consideration from someone in their early 20's or so, but what if you were in your late 40's or 50's?

http://www.newsobserver.com/news/loc...ry/229063.html

Published Mon, Dec 07, 2009 05:31 AM
Modified Mon, Dec 07, 2009 05:09 AM
<H1 id=story_headline>Doctors in upscale practices build niche in Triangle</H1>

Over the last few weeks, Dr. Brooks Wilkins' patients have been running him ragged, trying to get in to see him one last time.

Wilkins is not retiring. He's downsizing - and going upscale.

Starting Tuesday, Wilkins will treat only patients who pay an annual fee of $1,500 to remain in his new MDVIP practice.

MDVIP, which refers to both Very Impressive Physicians and Very Important Patients, is a national organization of doctors who aim to provide more personalized, preventive care for a select group of patients willing to pay a premium for the service.

Wilkins is the third doctor in Raleigh and the fifth in the Triangle to make the transition to MDVIP, part of a national trend toward "concierge practices." There are fewer than 10 such doctors in North Carolina and several hundred nationwide. Participating doctors trade in their thousands of patients for 400 to 600.

"I'm really excited that this will allow me to drill deeper on important health issues with my patients," saidWilkins, 60.

In exchange for a $1,500 fee on top of their regular insurance coverage, VIP patients are guaranteed more time with the doctor, an extensive annual diagnostic exam, and a cell phone number where the doctor should be available night or day. In addition, VIP patients get a compact disc with their permanent medical record and access to a network of other MDVIP doctors while traveling.

<SPAN class=z_idx_alfa>Dr. Bernie Kaminetsky, medical director for MDVIP, said a lot of doctors, like their patients, feel dissatisfied with the mill-like atmosphere of modern medicine - one patient after another all day long.</SPAN>

"It's like that famous 'I Love Lucy' episode in the chocolate factory," he said. "The chocolates on the conveyor belt keep speeding up, and you just can't keep up."

<SPAN class=subhead>Getting to know patients</SPAN>

Dr. Mitchell Hardison, who became Raleigh's first MDVIP doctor almost a year ago, said he had grown so disillusioned with medicine under managed care that he contemplated early retirement until his wife told him about the Florida-based "concierge practice."

"I used to spend perhaps 10 or 15 minutes max with each patient," said Hardison, 57. "I worked from 5:30 in the morning until 8 at night, and I always left with items undone on my desk.

"There were phone calls I couldn't return. There were a lot of things that I worried were falling through the cracks. It was not the way I wanted to practice medicine."

Now, Hardison spends at least half an hour, often more, with each patient. There are some patients he has treated for more than 20 years whom he's only really gotten to know and understand over the past 11 months.

Hardison said he even makes house calls to patients too ill or infirm to come to his office near Rex Hospital.

<SPAN class=subhead>When MDVIP really helps</SPAN>

Some patients are thrilled with the change.

Jack and Toni Davis became believers in early November, when Jack had a large blood clot in his leg. His symptoms showed up late on a Saturday night, and the Davises finally called Hardison before dawn on Sunday.

"He answered the phone himself," Jack Davis said. "He said 'I want you to get to Rex. A wheelchair will meet you at the door.'"

Hardison then guided the Davises through Jack's hospital stay and directed him to specialists as needed.

Because of the extensive exam Jack had undergone at the MDVIP transition, Toni Davis said, Hardison knew her husband's medical background in detail.

The Davises plan to sign up for a second year with Hardison later this month.

<SPAN class=subhead>Haves and have-nots</SPAN>

Some patients were not happy to receive the MDVIP letter from their doctors.

Janet Jester of Raleigh said she was outraged when she received notice from Wilkins a few months ago.

"I've been his patient for 20-some years," she said. "Now I have to pay $1,500 to remain his patient?"

She said she and her husband, both in their 60s, have always been very satisfied with their care. But they cannot afford the $3,000 to go VIP as a couple. It's the principle that really galls her.

"I really like Dr. Wilkins, but I told him, 'I think you're creating an elitist class of people,'" Jester said. "They have a separate waiting area for VIP patients. I think they're again dividing the haves and have-nots."

Gopal Sreenivasan, a medical ethicist at Duke, studies disparities in care. He said that for people who believe that everyone should have access to the same level of health care, the concierge model might be viewed as an insult.

But the truth is, he said, "there are differences in access to health care. Our health care system is really a patchwork of care based on what people can afford."

Michelle Piette, 57, another of Wilkins' longtime patients, thinks the shift to premium practices was inevitable.

"I have to admit, when I got the letter and saw the $1,500 fee, I was, like, 'Holy mackerel!' " she said. "But even looking at the cost, it's a choice I had to make. Having someone who knows me and stays on top of things is important to me. I take health care very seriously."

I agree with Niptuck, especially if Obamacare passes. I'd have no problem paying the $1500 yearly fee for such membership.

sound like a good idea to me. free market FTW

 

Originally Posted by Autolobotomist

I've been seeing the same doctor for a dozen years now. I refuse to see anyone else. If my doctor did this I would kick him in his newly reconstructed knee.

Wow, what timing here?!?! Our paper just ran a story this morning (I posted as VIP Doctor service), I would be for it without a doubt.

 

Originally Posted by OneM24

The sense of self entitlement in this nation has gotten out of control,

How you can say this, then go on with a rant filled with a sense of entitlement is rather amusing.

 

Originally Posted by Niceguy

then go on with a rant filled with a sense of entitlement is rather amusing.

I guess that depends on how you view things. My "rant" was about the sense of entitlement from the general population, but I'm sure you are speaking of the entitlement of the doctor to earn for his services. I believe the former is unwarranted, and the latter is deserving. The doctor has earned compensation for his services in this case, the general public has not "earned" the right to free medical care simply because somebody has the ability to give it.

I wouldn't do this, unless I needed a specialist for some reason, but $1500 sounds like a bargain. I know people who pay for their own insurance through COBRA and it is >$400 per month. I also think this was inevitable, but I also could see how it could be stemmed through legislation or something and these doctors will be obliged to see a certain number of 'public' cases if it becomes too common. I don't agree that's a good idea, because I think that these doctors are finding a way to stay motivated and I would not want to be treated by a doctor that was obligated but otherwise unmotivated.

 

Originally Posted by pistol45

I wouldn't do this, unless I needed a specialist for some reason, but $1500 sounds like a bargain. I know people who pay for their own insurance through COBRA and it is >$400 per month. I also think this was inevitable, but I also could see how it could be stemmed through legislation or something and these doctors will be obliged to see a certain number of 'public' cases if it becomes too common. I don't agree that's a good idea, because I think that these doctors are finding a way to stay motivated and I would not want to be treated by a doctor that was obligated but otherwise unmotivated.

The key thing to remember here is this doesn't pay for any services, just an up front access fee. It probably includes an annual physical and maybe an included visit or two, but any procedures, consultations, tests, exams, etc. can be billed in addition.

I have no problem with it in principal, I just hope people get their moneys worth and don't get scammed by a pushy sales staff/doctor's office.

The average person doesn't need this.

see capitalism can survive a public option.