Concierge 

Gerber Daisies

“The letter said I had to pay $2400 each year to remain a patient because from now on he was going to be running a concierge practice. I would still have to use my insurance and pay deductibles and such. He’s a good doctor but I just don’t have that kind of money!” She said it in a way that made it clear the she hoped he would not hold it against her that she would have to find a new doctor. It wasn’t his fault. It was hers…

Trust me, honey, I know him. He doesn’t give a rat’s ass.

I get told all the time that I ought to go into concierge practice. 

But I won’t. 

Not ever. 

The fact is, I would feel like such a sellout, I wouldn’t be able to live with myself.

Why do I hate concierge medicine so much? 

I want to believe that it is because I think healthcare should be equally good for everyone, not better for those who can pay more. Concierge medicine smacks of elitism. Maybe, though, it is because I don’t understand people that have that kind of money, that kind of entitlement. Yes, I have assigned an unfair stereotype, haven’t I? 

Maybe I am simply jealous of them?

And then I wonder at what point do I actually become one of those rich, entitled people? Is it when I become willing to pay the retainer fee? Or some point before? 

Do I have to have gobs of money to be one of them?

Is wearing a large chunk of fake diamond on my finger selling out, too, in a way? I have had it for just over a year now. People treat me very differently when they notice the “rock” on my finger and I have to admit that I like it, I like the deference and I feel dirty because I like it. And then I ask myself WHY does that make me feel dirty and not any number of other things from my checkered past? 

And so I come back to some level of jealousy. 

I am not noble. I am eaten up with jealousy and having to face that every day would be painfully difficult.

That is why I cannot do concierge medicine. 

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113 thoughts on “Concierge 

  1. My physician offered me the concierge plan, telling me how I would have much more access to him. I told him, “I don’t like going to the doctor. I come reluctantly once a year for my physical, why would I pay over $2000 a year for this when it is covered by insurance?”
    He looked shocked. I have now switched doctors to a person who served in the peace corp in Liberia. He offers no concierge plan and I don’t dislike going to the doctor quite as much……. You sound like a very good doctor. Don’t change and don’t doubt yourself. There aren’t enough physicians like you.

    Liked by 12 people

  2. I could see using a doc that does that, but only if I had a chronic condition that had me in and out of their office frequently. I go once a year for a physical. A retainer fee for “the right” to see her? Uhhhh…..that’s a big fat no. I bet that ladies doc did want her to do that. That’s an easy $2,000/year. And I bet it in no way makes it easier for her to get in to see him. Quite the little racket.

    Liked by 1 person

  3. Wow. This is the first I’ve heard of such a practice. I fully support the rights of parties to engage in mutually agreed upon transactions but I could have no part in such an agreement even if I could afford the fee. Such a proposal would give me the impression that I was resented as a patient.

    Liked by 1 person

  4. There was an earlier period in my life when my ex-wife and I made enough to consider a concierge doctor. We got as far as the waiting room for our scheduled first consultation (to see if the doctor would first agree to accept us). A receptionist offered each of us a small bottle of Perrier. We both looked at one another, politely turned it down, and left.

    Liked by 2 people

  5. You’re talking to the grandmaster ninja warrior of envy. My body composition is mostly water but the second element is jealousy. But at least I have my feet on the ground. I acknowledge it and dismiss it for what it is. That’s what you do, too, I gather. A concierge practice is parasitic. Against everything that’s good about humanity.

    Liked by 1 person

  6. Some doctors have tried that here. I think it’s illegal with our health care system. I wouldn’t/couldn’t pay that. The only time I see a doctor is when I need one and we have walk-in clinics for that and they are covered by our healthcare system.
    Leslie

    Liked by 1 person

      • It is easier to be seen by a physician in a walk-in clinic than it is to be seen by my physician. With my physician I need an appointment in advance and there could be a couple of hours waiting in her office, to be seen by her. In the walk-in clinic it is first come first served and there may be only a 15-20 minute wait to be seen. So for emergencies the walk-in is clearly the way to go.
        Leslie

        Liked by 1 person

  7. “Concierge medicine”? What the actual f**k?
    The US really seems to be another world (dystopian). I fear the Conservative government likes the idea of concierge medicine – they seem determined to undermine the NHS. 😦
    I love your principles in an incredibly important profession in an uncaring world.

    Liked by 2 people

  8. I don’t like the idea, but it’s like so many other things. Think of airline seats. I’m not suggesting a comparison exists, but medical care seems to be treated more and more like a commodity every year. Honestly, I get more personal time with my car mechanic than my doctor. I wish I had a doctor who cared as much as you do.

    Liked by 1 person

  9. Oh good gravy! Can anyone out there remember the day when your family doc made house calls? I can, plus he had a thriving downtown practice with 1 starched-white-uniform-plus- little-nurses-cap nurse named Dorrie and 1 receptionist who did everything else. Pay thousands for “better access”- that’s a joke!

    Liked by 1 person

    • Back then insurance was not an issue. Over 1/2 of my staff is here to do battle for patients and for me against the insurance companies. I did a couple of house calls when I first started out in practice. I really wish I could do more of that.

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  10. As a patient, I hate concierge medicine too. It’s not that I don’t think my doctor is worth it, but the amount of $$$$$ I spend on my medical care is astronomical. Extra charges? No.

    But I have one that’s worse — my old gastroenterologist from the 1980s stopped taking insurance all together. He is out of network for everybody — and folks are expected to pay up front. Uhh, no. He retired a couple of years after he and his partners did that. They were great doctors. His partners probably still are. But who can afford that except all the folks currently in the Trump Administration being paid off by the Ruskies?

    Liked by 1 person

  11. I have never heard of concierge medicine, sounds totally unethical and illegal. Crap, we can’t even take a pen from a pharmaceutical vendor. You would never do this. And the ring…. its all about the bling. I get it. I wore a fake ring for years. Now I wear three different diamond bands and a rock and they are all real. I call them my payback, since the rock came from trading in my “wedding set” from my first marriage and other “gifts” he gave me. Them my current hubby has bought the bands in celebration of our marriage. So I wear those with honor. Good jewelry makes you feel good! Yup, I am a material girl and diamonds are my best friend!!!!

    Liked by 1 person

    • Speaking of pharmaceutical vendors, I checked my online reporting thing where the government publishes how much money I have taken from vendors. $175 reported. A bunch of BS. I never takes meals or anything else from reps. You know what the average is? $1400/yr.

      Like

    • I like people who don’t like bling. They are my people, generally speaking. Which is why the ring makes me feel like a dirty sell out… When exactly did I start caring? I still don’t care about what someone else is wearing on their finger. It doesn’t change how I treat them. So why am I caring about this stupid fake ring? It is probably time to get rid of it, trade it in for a simple gold band, you know?

      Liked by 1 person

      • I totally get it, because I faced similar judgment and circumstance regarding status when my husband was serving his country. It’s odd, but it’s a relatable topic for me.
        Before my husband’s 15-month deployment, one of the other wives actually said to me, “OH MY GOD, he could die and you don’t even have a diamond from him!” Nodding all around. He bought me a diamond ring the following week. Guess how much it changed our marriage? Not a smidge. Guess how much it changed my status as a military spouse? Considerably. It’s almost as if the bling tells people our value in relation to someone who may not even be present.
        I never belonged, for a multitude of reasons, that being one.

        Liked by 2 people

  12. Thank you for believing that quality healthcare should be available to all. I can’t tell you how much that means to people who could never pay those fees. We only get this one life, and it’s not a pair of fancy shoes or a swanky car that we can do without. Doctors who look at each life as something worthy of care, regardless of financial circumstances, are angels.

    Liked by 1 person

    • The vast majority of physicians believe it. I hate that a few don’t because their actions seem to speak louder to everyone than the thousands of others that keep plugging away at something they believe in. Frustrates me to no end.

      Liked by 1 person

      • Oh. Over here it depends . If you want a longer consultation you pay for it. Standard ones are the short ones.
        Same day in depends on the doctor. If like mine I always get in on the same day. It’s only if your doctor works part-time then it might not be the same day.

        Liked by 1 person

  13. I do think concierge medicine is elitist. My former doctor chose that option. He definitely did not need to; he was part of a thriving practice.
    I was also raised to feel like having a lot more than you needed was somehow “dirty”. Is it? I still haven’t worked that out, but I definitely have more than I need, while many have next to nothing. In my heart of hearts I am always uneasy about it. Back to that unanswerable question: what do we “deserve”? (K)

    Liked by 1 person

  14. That’s a really high charge for a year – I know a few concierge docs and they do it for a lot less because they want the volume! I also have a rock on my finger – it’s real – but I gave the one I had before to my daughter (actually to her fiance at the time) for her engagement ring, because she wanted it. My dear Hubs bought me a bigger one.

    Liked by 1 person

  15. We have come a long way from house visits, haven’t we. Seems like a time that never existed. I wonder if people sold their souls back then and we just didn’t notice it. Either way…it seems a bit obscene.

    Liked by 1 person

  16. I never knew there was such a thing. We did have to use private health care when we went through IVF. It was horrible care. They saw us a $$. They almost killed me on more than one occasion with their mistakes had I not spoken up for myself. Is this the what kind of thing your referring to there?
    Oh and enjoy your ring. Nothing wrong about having that. 🙂

    Liked by 1 person

  17. You have started quite a conversation here. I understand what you are saying about jealousy. I think there is a little of that in all of us. Once upon a time, I loved to dress up and put on my “Mrs Got Rocks” jewelry. Inherited. It was fun to see how different I was treated than when I went in my everyday garb. I want to be treated well no matter how I dress. Medicine is a tough field. I’ve been used to military medicine or an HMO my entire life if I had any care at all. Most often we were without insurance and health care for us was out of pocket, aka credit card. We were poor enough that we fell between the cracks. If it weren’t for medicare, I would still have no medical care so concierge medicine is not something that has ever crossed my mind. I’d almost like to see insurance gone and pay as I go return other than for catastrophic illnesses. We’ve lost something here and in many parts of the world. There are no easy answers. I just make sure I don’t get sick.

    Liked by 1 person

  18. Just because you have those feelings, does not mean you are not noble. It means you are human. I love your authenticity. I know there are rich people who are also good people, but I tend to have a bias against materialism. I forget how much my diamond engagement ring cost – probably something modest. Otherwise, I get my jewelry for less than $5 at the thrift store my husband manages. If I think it’s pretty, I buy it. If you like your ring, wear it when you feel like it.

    Liked by 1 person

  19. I started reading, then I stopped and went to google to ask what the hell you were on about. Now I’m back, ‘cos I don’t believe it.But then again, there’s a lot about your system I don’t believe. Still it migh make medical practice great again.

    Liked by 1 person

  20. In the little town I lived in, a MD and his daughter in law MD started one of these practices…working in the health care field, I was able to ask other MD’s what their thoughts on this was. the biggest majority said, it must be nice to feel your above the rest. They didn’t see it as offering something special to their clients,. but weeding out the poor and only giving there precious time to those that would be willing to pay for it. It happened the Senior MD came in the facility I worked at, I had spoken to him many times before, infact we had had many conversations about his love of cycling, he volunteered to be the team MD of the cycling team from our city, some of the men on that team rode in the Tour de France, so it was an important position to have. He was always nice and loved telling stupid jokes, we all laughed of course, it would of been rude not to, LOL, however as he was leaving, I ran out behind him, and told him I just had to know why, he would of changed his practice, he stopped and thought for a minute and said you want the truth, I said always…he said it wasn’t his idea, he was perfectly happy with the way he was running his practice, but his daughter in law took over the inner running’s of the office and it was all about what she wanted as he was getting ready to step down and retire from his office, he was going to do volunteer work at benefits for the cyclist around the country, something him and his wife held dear to them, his son, another MD, became a cyclist and left his practice years before. So I walked away feeling better about this man, who I always thought was a stand up person. I had meet his DIL MD and she was a bit of a snob, couldn’t talk to the little people….only spoke to the Director of the facility about her clients even though I was the one processing her orders.!! It made perfect sense to me after that. Let her have all the wealthy of the city, snobs that they all are!!! sorry about the rant,, but I really dislike MD’s who have the God mindset!! xxkat

    Liked by 1 person

  21. I know what you mean about the fake diamond, Doc. It’s amazing, isn’t it?
    When I got mine I meant it to be something to help me “manifest” prosperity; a symbol. I compulsively tell people it isn’t real when they comment on it. I chose that particular ring because of its vintage look. Never having known a *caring* family, the setting made me imagine a great-great grandmother passing it down. I’ve been wearing it for ten years. Every time I go to a restaurant with a group, the wait person acts as if *I* am the dominant person, then the manager comes to the table. It’s fascinating.
    Wishing you a sublime Sunday. Hugs.

    Liked by 2 people

  22. Why don’t they call it what it really is ?
    Racketeering Medicine..

    Glad you smell the stench of it and want no part of it..
    It’s gotta be very hard to practice good and fair medicine as a Dr. these days.. Alaska probably needs Drs. like you without all the red tape tangling the works.. If you ever move to practice in Maine, please announce it, I’d be very comfortable with you as my primary physician !!!

    Liked by 1 person

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