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You Could Soon Be Paying Your Doctor Directly With No Insurance Middleman – Can You Afford ‘Concierge’ Medicine?

More doctors looking at direct-pay medical practices
(Photo by Joe Raedle/Getty Images)

Don’t look now, but direct pay is fast building momentum in the medical community.

Some alarming statistics from the New England Journal of Medicine show doctors could be dropping from the medical profession:

  • 46.3% of primary care physicians (family medicine and internal medicine) say that the passing of health reform will either force them out of medicine or make them want to leave medicine.
  • 27% of physicians would NOT recommend medicine as a career if Obamacare passes. (36% would not recommend medicine as a career, regardless of health reform.) 
  • 62.7% of physicians say that health reform is needed but should be implemented in a more targeted, gradual way, as opposed to the sweeping overhaul that is in legislation.

So how are doctors going to deal with these problems? According to Forbe’s Magazine,  increasing numbers of physicians are going to switch to what is known as “concierge” medicine. Also called direct-pay, these doctors set up contracts with patients to supply varying levels of medical care.

Some see it as a throwback to old-school medicine, when the doctor dealt directly with his patients. Most don’t come to your home, but the personal relationship is the same. Some 9.6 percent of doctors in the next one-to-three years plan to move in this direction, according to physician staffing firm Merritt Hawkins.

In late 2012 and early 2013 the firm talked to thousands of practitioners across the country and found this to be an increasingly-attractive option.

Why are doctors considering this? Largely due to uncertainty over Obamacare, and exactly what will happen with insurance companies. Doctors are unsure what the medical playing field will look like by the time the Affordable Care Act is fully implemented.

Another big issue is continuing cuts in the Medicare reimbursement to doctors. According to a 2010 American Medical Association study, one in five doctors are restricting the number of Medicare patients they will take on. One in three primary car doctors are doing the same. With Obamacare taking billions away from senior medical programs, the Medicare situation for seniors will not be getting any better.

These physician cutbacks are also seen in state-run medical programs such as the Department of Social and Health Services. United Health Care and Molina are finding fewer and fewer doctors willing to accept them. The reimbursement rate has reached a point where it’s just not economically feasible for doctors to accept these patients.

The idea behind direct-pay (or “concierge”) medicine is simple, says Forbes:

Under direct primary care, doctors contract directly with patients to provide all of their primary care needs free of insurance interference at a price generally between $50 and $60 a month per patient.

 

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