Funny that you say you are not attacking concierge patient’s intelligence – and then you immediately attack their intelligence – “will not understand.”
You must not understand that no concierge patient receives services until they have paid their bill – pretty difficult not to understand when you already purchased the service.
There are Medicaid patients whose parents are employed and covered by their own non-Medicaid insurance. Why wouldn’t the parents want to have the whole family skip the lines and have access to their family doc via email/phone/guaranteed same day access? Have you even been to a clinic where Medicaid patients are receiving services? They are no where near as homogeneous as you seem to think – some of them pay monthly for data plans and for cable TV – why should they balk at paying for a premium service that is even more useful than cable TV? I don’t hear anyone calling for Medicaid patients to be forbidden to have a data plan on their phone – why shouldn’t they be allowed to have a premium plan to access the physician that they trust? Especially when all they have to do to pay for it is cancel their cable and get a set of rabbit ears.
I for one don’t think Rob should have given you a pass on your tone.

And you say that Medicaid patients are interested in Concierge services you provide? Seriously? And you think that’s a good thing? It they are Medicaid patients they have money to spend on Concierge services. Unreal.

BTW, If you think that anyone who reads a blog post must read all of your previous blog posts to gain context and understanding about your blog post, then that seems rather presumptious of your readers. Maybe you could add a reference to previous posts that support what you think should be obvious to new readers?

Obviously you are late to this, so I’ll overlook your tone. My readers know that I am going to this type of practice because “traditional” care wasn’t making me enough money, it is because I couldn’t give good enough care. All of these answers have been given at length in previous posts over the past few months. My patients know this is no substitute for insurance and that insurance won’t cover my monthly fee (which ranges from $30-60/month) because I’ve told them. Those who are waiting for the practice to reopen are following me on facebook (where my posts are re-posted), are getting my newsletter (where I spell this out) and many have asked me in person.

Of interest, most of those who have expressed a definite interest in joining me are Medicare patients, and some are Medicaid patients. Those with no insurance (which numbered over 500 in my old practice) are thrilled by the prospect. Businesses have approached me with the possibility of pairing this with a high deductible plan and saving money.

I find it interesting that you attack me because I do this, yet you seem to have a very low opinion of my patients’ intelligence. They are not dumb, and I don’t treat them as if they are. The support I am getting from my patients has been quite amazing, even from people who are not able to stay with me. I guess that’s because I took the time to explain things after listening to their questions (as any good doctor should). And that’s exactly what I’ve done to make sure they understand exactly what I am doing.

The number of local docs (many of them much less outside-the-box thinkers than me) who have told me that they are ready to bolt if I can show it works has shocked me. It really shows the level of pessimism doctors feel about our system. It bears out the recent study that shows only 15% of primary care docs happy with the system, and I think it goes much deeper than that. It’s scary.

What do you think the payors can do (specifically Medicare and Medicaid) to prevent this from happening? My greatest fear is that there will be a mass exodus which will result in the requirement that docs accept Medicare to be licensed. I’ve heard rumblings of this and it really scares me. I think you would then see docs leaving medicine altogether.

This is part of the reason I feel the need to try to grow this back to the same patient numbers I had in my old practice (see my post on the “organic medical home”) through use of nurses, midlevels, social workers, and other allied health professionals. I don’t want lawmakers to get desperate, as it greatly increases the likelihood of them doing something very destructive.

You are so funny….. 🙂 Am I that predictable?
No, of course not…. I meant the sensible stuff….

Don’t tell me. The Senate Finance Committee could fix this by putting in single payer??

The physician access crisis may be authentic, but it is entirely “man-made”, preventable and curable, if only…. but you know all that…