Portland, Oregon

Portland, Oregon

Sunday, January 17, 2016

Concierge Medicine

I noticed our family practice doctor had become frustrated and angry with the financial side of medicine in this country.  At the time I didn't think too much about that but I should have stopped right there and changed physicians.

We liked this young man, or at least we had at one time.  It became apparent once he went into private practice he was not capable of managing an office.  He began to blame others for his problems.  He felt he had been misled into family practice medicine when specialists were making a lot more money than he was seeing in his practice.  He was angry about Medicare, and insurance companies in general.

In time I received a phone call from his office inquiring if we would be interested in retainer fee/membership medicine.  Next came the letter informing us our doctor was changing his practice to this kind of medicine.

The thing that quickly grabbed my attention was he would no longer accept any forms of insurance.  Medicare/Medicaid claims cannot be filed by the patient so even if we'd been inclined to stay with his practice that alone would have been a deal breaker.

For a retainer fee he would be offering some services each year but anything above that the patient would pay up front and file their own insurance.

Knowing this young doctor I knew he was all about a more lucrative practice for himself but I also knew he preferred to practice preventive medicine.  He did not enjoy treating chronic conditions.

While I have no doubt the frustration level among doctors is high over insurance and Medicare I did not see the masses rushing to concierge medicine.  Doctors in our medical community were puzzled over our doctor's decision.

At this point I lost respect for our doctor.  I also felt bad for him because I felt his choices were going to disappoint him and lead to more anger and frustration.

If his choice worked he would have set up the following things:

1) Set in motion a two-tiered system that favored the wealthy.
2) He would no longer see the elderly or the poor as he would not accept Medicare/Medicaid.
3) His practice would be smaller allowing the time needed to care for his retainer patients.
4) He would not see patients with chronic illnesses as they must rely on insurance.  Why go to him and have to file your own when doctors' offices all over town file insurance for you?

We're now some two years out from all this.  His practice has gone bankrupt and my understanding is he's left the area.

My next post will be about choosing a new doctor.


  1. Good post! If medicine is only about making money and only treating the easy conditions, then that is not public service at all. Some doctors might not like to think they are public servants, and they certainly want to demand more than "servants" pay, but that is their purpose.

  2. I read an article in our local paper about a year ago regarding an area doctor who had switched to concierge medicine. Hmmm. I wonder how he's doing. Our good friends had to scramble and find a new doctor when their family doctor closed his practice to work for an insurance company. The state of private medical practice in the US is in trouble. I'm eager to read of your search for a new doctor. I'm sure the search was a challenging one.

  3. Good to see you blogging again. You were missed. One of my doctors years ago started doing that and priced me right out of his practice. Think I will Google his practice and see if it is still in business. Sadly I feel the doctors who do this are really in the wrong business. They should be on Wall Street. Hope you have no problem finding a less greedy and lazy doctor.