By Tammi Tan | January 15, 2013 — My private practice is closing.
I stared at this notice in disbelief. My trusted primary care physician informed me that she would be closing her bustling practice and joining a concierge practice. This just couldn’t be happening to me.
Actually, I shouldn’t be surprised. General practitioners had an average move rate of 14 percent over the past five years, and over the last year we have been hearing about the demise of the solo medical practice. Pressured by high overheads and other issues, physicians have been moving on to group practices or taking up positions in hospitals in recent years.
In the letter explaining her transition, my doctor brought up the same issues that many other solo practitioners face. Decreased insurance reimbursements meant she had to see a high volume of patients, which prevented her from giving the quality of care she would like to provide to patients.
Dr. S is a wonderful doctor who has given me excellent care. During my last visit I could feel that she was clearly torn between wanting to spend more time answering my questions and having to rush off to the next patient in an extremely busy day during the height of the flu season.
I would have loved to join Dr. S if she’d simply moved on to a group practice. But since she joined a membership-based concierge medical practice
, following her is not an option for me. Before anyone thinks I have something against concierge practices, let me explain why.
In order to keep receiving care from my trusted doctor, I would have to fork out an additional $300 every month. This fee allows me access to my physician, but it does not go toward any treatment or consultation. In return I receive more focused care, more time with my physician during visits and benefits, such as same-day appointments.
As much as I would like to continue seeing my doctor, an extra $3,600 a year is not a sum that I am able or willing to pay. Concierge medicine has proliferated since the ‘90s, and while it is no longer exclusive to the wealthy, it is not always affordable for the average patient. According to a Government Accounting Office survey
, annual retainer fees for concierge medicine ranges from $60 to $15,000, with an average of $1,500 per patient.
Concierge medicine does have its merits. As Dr. S explained in her note, an average physician sees an average of 25 to 35 patients a day in private practice. In a concierge practice, she will see no more than five to six patients, allowing her to dedicate quality time to each patient.
While I understand it is a business decision, I am still definitely impacted by the move. It looks like I have to embark on a search for the next family physician who can hopefully provide a similar standard of care. And hopefully I don’t find myself in a similar situation in the near future.