National Headlines

Dinerstein, M.D. | Everyone Wants Value in Healthcare, We Just Disagree on What That Means

Concierge medicine is a growing trend. You pay your physician an additional fee (in the $1,000-2,000 or more range), and in exchange, the physician accepts your insurance payment, restricts their practice size to provide individualized care – you have their cell phone number, and they are available 24/7/365. For the patients, it is about service; for the physicians, it is about having the time to provide a bespoke service. The survey did suggest why such a practice is a value proposition for both physicians and patients. When asked, patients did not want to spend more money, believing, I suspect that physician payments were adequate. Physicians wanted higher payment for the additional time and effort in customizing care or extending visits as well as communicating outside office hours – in a word, for what they perceived as service rather than health quality. When asked about getting “treatments they want,” 53% of patients were willing to pay more; and 63% of physicians would charge more to provide those requested services.

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By Chuck Dinerstein — December 29, 2017 | Dr. Charles Dinerstein, M.D., M.B.A., F.A.C.S. is Senior Medical Fellow at the American Council on Science and Health. A retired vascular surgeon, he also writes a “more philosophic” blog at Surgical

Value-based healthcare is the refrain for all the stakeholders, patients and their advocacy groups, physicians and their societies, payers both insurance and government. We must replace payment for volume or procedures with payment for value. As it turns out, like the blind men describing the elephant, what each stakeholder means by value varies tremendously. An online survey conducted by the University of Utah sheds light on our misaligned definitions of value. As they write, “… stakeholders have been talking past each other, not fully understanding each other’s perspectives, experiences, and concerns. We are often using the same key words to mean different things.”



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