Why is medicine becoming so frustrating? For patients and for doctors: Concierge Medicine may be the answer   

Healthcare has become a frustrating battleground for both patients and parents. Pediatricians, like other areas of medicine, are seeing burn-out at unprecedentedly levels. Parents are trying to raise children with less and less social support. So how can concierge medicine help both?

Case Study

Here is an example from how our concierge practice may seek to bridge some of the current areas in healthcare service leaving patients wanting.

A mother rushes through the end of her work day to pick up her 10 year old son, Jack, from school. He tells her his ear is really hurts. It’s 3:30pm. Jack has 1 hour to do his homework before soccer practice from 4:30-5:30. When he get home from practice he has 30 minutes for dinner, 30 minutes to shower and pick-out clothes for school tomorrow and then 15-20 minutes to wind down for bedtime. Also Jack is one of three other children. Jack’s mom is worried that he has an ear infection but also knows a doctor’s visit either means a significant amount of time during the day in the office. Thanks to the latest in Telehealth technology, Bee Kind Pediatrics has a device that allows Jack’s mom to take a picture of his ear drum. Using artificial intelligence, it sends a perfect exam picture (better than you might get if you actually went to the doctor) to a HIPPA-secured email. Jack’s mom can take the picture on her own time and email it to the doctor, who can then review it that same day and call in a prescription if needed to the pharmacy and call or text Jack’s mom to discuss the plan and findings. The whole process may take less than 10 minutes. Jack’s mom and the doctors can text or have a call the next day to see how he is doing. Making is as convenient as possible and using cutting-edge technology provides next level access to healthcare and ensures excellent care for Jack.

So why do you need to be concierge to do this? Well, not all cutting edge technologies and convenience options are cost-effective to an insurance company. The bottom line is that the decision-making is not directly between the physician and patient, a third party enters the discussion.

The heart of the problem 

Insurance reimbursement rates have continued to fall leading to physicians to have see more patients in order to just pay the bills and keep their offices open. In order to see more patients, doctors are forced to spend less time with their patients. Spending 10 minutes or less with a patient leaves many doctors feeling like they are not providing the quality of care they wish to. So even though a doctor may work very hard, they often feel like they are not doing a good job. The combination of long hours and feeling like they are not providing the quality of care they hoped to has left many healthcare providers burnt-out.

So what? For many patients 10 or 15 minutes with their doctor just is not enough. Many patients only see their physician once or twice a year. Due to difficulty accessing their healthcare provider (because doctors are seeing a patient every 10 minutes all day long and then charting and billing after) patients often save all their questions for this one visit. Trying to really explore topics of concern and provide good preventative care guidance requires more time than most doctors have. Which leaves doctors with two options: spend the time and not collect enough money to cover their costs or see as many patients as they can in a day. What if there is a third option?

Enter concierge medicine: the solution?

Concierge medicine allows physicians to deal directly with their patients. Cutting out third parties, like insurance, allows physicians to decide how many patients they can see and still provide quality. It also allows physicians to offers services, like home visits, that third parties may not view as a valuable service but perhaps patients do, and still keep their doors open.

Many parents feel like their physician is either not listening to them or does not understand the concern. This is often because the typical physician is allotted 10-15 minutes to talk with patients, which may not allow them to provide this care. While every concierge practice model is different, many providers are able to offer hour long visits. For Pediatricians that means watching a child play to fully assess their development, discussing important topics for guidance like sleep, taking a deep dive into their nutritional needs. If the provider is also able to do home visits they can access their patients sleep environment, watch them play with their own toys in a space they are comfortable with (allowing for even more accurate developmental assessment).

While all concierge practices are different, for Bee Kind Pediatrics, the concierge model allows us to provide mother’s of newborns in home visits. That means, for a mother who is still recovering herself she does not have to drag herself and new baby to the doctors offices but instead can wait for the doctor to come to her.  She can nurse her baby in the comfort of her home while her pediatrician evaluates the baby and provides lactation advice. Staying home also means less infection risk for the newborn.

Beyond longer healthcare visits. Concierge medicine can provide parents and patients with more access to their doctors. Many concierge doctors give their patients 24/7 access to them by phone or text. This allows parents to get answers from the doctor directly when they need. By having less patients overall, doctors can be more available and accessible to patients, eliminating the need for answering services and nurses lines. This kind of style of medicine is really an ode to “the good old days of healthcare”, when there was the one “doc” in town and everyone had their number and they came to the house with a doctors bag.

So, for some doctors, concierge has become a solution to allowing them the freedom to practice in way they feel is best. Just as for some doctors concierge has become the answer, so too for some patients.

Does it matter?

For our practice, having less patients allows us to provide more follow-up for things like sick visits. We can check in with families multiple times a day or daily and if needed provide guidance to keep children at home then in the ER. Earlier interventions for disease processes, like acute asthma exacerbation, have been shown to reduce ER visits and hospital length of stay.

It takes time to fully observe a child in early to really assess their development. Earlier detection of developmental delay allows earlier intervention, which has been shown in multiple studies to result improved outcomes.

Concierge can mean physicians to determine and operate their practices in way they deem enhance the quality of care. For example, advanced telemedicine as opposed to the minimum cost Telehealth platform allows patients to again have reduced ER visits and more advanced diagnostic capabilities. This gives families not only the benefit of reduced ER visits but increased access to their physician allows families freedom to travel and still have their doctors if needed.

We know that providing good guidance for what parents can anticipate in the future prevents illness. For example discussing topics like sleep routines at earlier visits results empowers parents with knowledge and results in improved sleep outcomes for children preventing sleep disorders. Likewise, discussing topics like bottle use and introduction of sippy cups can help mitigate future dental as well as speech issues. All of this requires physicians have adequate time with their families.

What about insurance for emergencies?

Many families have insurance for their children as part of their own policy. Insurance is still helpful even if you have a concierge physician. Insurance companies will still pay for emergency room visits, hospital visits, x-rays (and other radiographic studies), blood work when needed. It is also helpful if you child needs to see a specialist and they accept insurance. Additionally, insurance is important your child needs a hospital-based procedure.

In some cases, a membership to a concierge practice may save you money. For example, at Bee Kind Pediatrics, we have staff who also have additional training in pediatric emergency medicine. Say your child has a simple laceration. The cost of this procedure in an ER or Urgent care may be $400-$1,2000 plus an hour plus in the waiting room. We have the ability to come to your home or see you immediately in the office, provide anesthetic, sterilization and laceration repair. The cost of which is included in your membership.