Is a concierge doctor worth it?
January 31, 2013 7:26 AM   Subscribe

I've been very disappointed with my doctor--she's obviously rushed and makes simple mistakes (like writing me a prescription for an over-the-counter medicine, telling me I need bloodwork but then not testing for the things she said she was going to, etc). I've also felt on several occasions that she didn't really listen to what I was saying to her. I'm thinking of joining this concierge medical center but I wanted to hear other people's experiences with this form of health care first.

I have a number of vague health concerns (something which might be allergies? tiredness? lingering physical symptoms of depression--after years of guinea piging I've finally found something that alleviates the emotional/mental pain, but things like exhaustion, weight issues, and painful intercourse are still around (in talk therapy too, don't worry)) and I'm interested in seeing someone who can see my health issues in an integrated way without dismissing everything as psychosomatic and/or treating everything as an isolated pathology. This post was helpful, but I'm looking for a first-hand experience of the concierge model. And if anyone has any direct experiences in the Boston/Cambridge/Somerville area that would be ideal.
posted by Calicatt to Health & Fitness (21 answers total) 9 users marked this as a favorite
I go to One Medical in SF. They are so great. Everyone is nice; you pick the level of appointment so if you need an hour you get it; and all of my docs have been very holistic in approach. Can't recommend it enough.
posted by dame at 7:46 AM on January 31, 2013

My wife and I use One Medical in the Bay Area, and we highly recommend it. While there's no guarantee that you'll see eye-to-eye with any given doctor, One Medical has provided very good care, and their integrated record-keeping makes it very easy to choose/interview/switch providers within their practice. Their flexibility with scheduling appointments, online management of medication refills and the ability to email your provider about non-urgent issues are well worth the yearly membership for us.
posted by eschatfische at 7:47 AM on January 31, 2013

I used to belong to One Medical in SF. While I agree with eschatfiche about those particular conveniences, I wouldn't call it a cure all. They were fantastic for specific requests (I have a cold and need a strep test, does this lump need a biopsy, birth control consultation) but just as hit and miss as any other doctors when it came to diagnosing/addressing more nebulous issues. Happy to provide more specific detail over MeMail. With what you've described I'd only go with them if a particular doctor at One Medical seems like a good fit to you.
posted by animalrainbow at 7:53 AM on January 31, 2013

I am also a One Medical member, and I recommend it for its flexibility and service. I received after-visit emails with helpful information. However, I found its pricing high for the one visit I made. I am continuing my relationship with my "regular" doctor just in case for the economics. (Don't tell anyone I am two-timing.)
posted by ClaudiaCenter at 7:54 AM on January 31, 2013

I belong to One Medical in NYC and love it. Highly recommended.
posted by dfriedman at 8:05 AM on January 31, 2013

If you have the money to spend and are worried your doctor is rushing, when you ring up book a double or triple appointment. The doctors will spend as much time with you as you like if you are willing to pay for it, and they know they have the time booked out for you. Though your current doctor doesn't sound great to start with.
posted by wwax at 8:14 AM on January 31, 2013

The nice thing about one medical is that you're only out the small yearly fee ($100 back when I did it).

I loved the next day / same day appointments thing.

Look, if you already have an awesome doctor, these guys are not going to be head and shoulders above the rest, but they're pretty good, and they're responsive. I agree with others that you will likely need to advocate for yourself, as they seemed more like "if you have a problem we will fix it" sort of place, but I only went there maybe 3 times, and at least 2 of those times, I was sick.
posted by Phredward at 8:21 AM on January 31, 2013

I use One Medical in NYC. They're well worth it in my opinion- last year I broke out in hives and it took two weeks to track down the trigger. My doctor was fabulous, super accessible by email, and I never felt rushed when I visited the office. In my opinion the email access to your doctor alone is worth the annual fee.
posted by lyra4 at 8:36 AM on January 31, 2013

There are a couple things that stand out to me in your question.

Writing a prescription for an over the counter medicine is thoughtful of a doctor to do rather than a mistake. Just because you don't need a prescription to purchase the medication doesn't mean the prescription won't necessarily be useful to you for other reasons like insurance.

Also while there are plenty of asshole doctors who think this way, using a psychosomatic model for understanding symptoms really isn't inherently dismissive - particularly if one has symptoms honestly are psychosomatic in origin. Lots of people have psychosomatic symptoms, I have a really nasty cough that is psychosomatic in origin, and it is really shitty that most people think of that as somehow embarrassing. Really, its an awesome thing to discover because there are effective ways to treat it.
posted by Blasdelb at 8:45 AM on January 31, 2013 [4 favorites]

I'm a One Medical member in DC, and though I can't speak for the other cities, I've been very pleased with the doctors and staff I've interacted with here. I don't expect them to be House-level diagnosticians, but whenever I've needed/wanted it, they were happy to recommend specialists if there were questions or issues they couldn't address themselves.
posted by evoque at 8:58 AM on January 31, 2013

Do it.

I'm also a One Medical member in NYC. Super recommend. Honestly, I can't say enough good about them—this coming from a severe doctor-phobe.

I've been for all kinds of things: preventative visits, lady visits, referrals to specialists*, broken ribs, a third world stomach virus, and a couple rounds of the horrible death flu that's been going around, and a nebulous, mystery illness.

Their offices make me feel very comfortable, and I like how the practitioners all just go by their first names.

My GP spends around 20 minutes with me per visit, when the national average is around 7 minutes. (I think.)

*Their network of specialists is so great, ps. I love my new dentist!
posted by functionequalsform at 8:59 AM on January 31, 2013

Wow, One Medical sounds amazing - do they take insurance or is this just something for people who can afford this level of care?
posted by exhilaration at 9:44 AM on January 31, 2013

I have a private concierge doctor that my boss kindly pays for. He has a limit of patients he takes on (never more than 300 people, or something like that). Some people see him once a year. When he first took me on, I was in recovery after a minor stroke, and we had standing appointments every couple of weeks. The first meeting I had with him blew my mind - we sat down and talked. And talked. And talked. TWO HOURS of chatting to find out who I was, how I lived my life, what we needed to do to get me better. Each "session" was literally at least an hour or more because we spent so much time on results of the last blood test, how my exercise regimen was going, how my quitting smoking was going, etc.

Because he has limited patients, he knows each one of us intimately and I feel he goes above and beyond what most doctors do (and believe me, my dad is a doctor!). For example, he happens to treat a friend of a friend. When the diagnoses of early onset Alzheimer's came in, he literally had the room set up in a really tranquil, serene way so that the discussion of the devastating diagnosis could be done as gracefully as possible.

I'm not privy to what my boss pays him, but I'm guessing it's a set fee of a couple thousand dollars a year, whether I see him once a year or twice a month.
posted by HeyAllie at 10:14 AM on January 31, 2013

Oh, to clarify - while his doctor fees are paid for, the medical services I use (prescriptions, blood tests, etc.) are all filtered through my own private health insurance. If I used my private health insurance to see a doctor, my co-pay is something like $50 a visit.
posted by HeyAllie at 10:16 AM on January 31, 2013

Wow, One Medical sounds amazing - do they take insurance or is this just something for people who can afford this level of care?

No, they take insurance. I have a generic big insurance company PPO and they work well with it. The way it works is that you pay the annual fee ($200 in NYC right now) and on your first visit they take down your insurance info. They bill your insurance same as any other doctor. Similar to any other doctor, you pay them until you reach your deductible, things not covered by insurance, and so forth.
posted by lyra4 at 10:44 AM on January 31, 2013 [1 favorite]

My experience with a concierge practitioner has been great -- but he was my doctor back when he had a conventional practice, so I already knew him. Is there a way you can meet some of the doctors before you join? Even a 10-minute chat in person would help a lot.
posted by wryly at 10:48 AM on January 31, 2013

I am in Seattle. I have a private concierge doctor who is available at all times -- and I mean really available. His practice charges about $2000 a year for concierge services, in addition to billing insurance. He has supervised ER visits, been around to order quick changes to my infusions at the infusion center (they generally have to go through a complicated paging system and I'm able to just hand them my doctor's cell number). I'm also able to get same day appointments whenever I need, where he takes all the time I need to address multiple health concerns, never in a rushed way. I am seriously, chronically ill, so I am probably more high needs than you. However, I honestly think this level of primary care would benefit anybody (and probably save on specialist treatment).

How I think his services would benefit any patient:
-the same day appointments and ability to stay in contact by phone and email save me trips to urgent care (and sometimes even trips into the office; he prescribed me Tamiflu over the phone when I had the flu this month); I also never have any uncertainty about my health, and I'm held to a higher standard of preventative care (the concierge fee includes diagnostic tests like an EKG and body fat analysis and diet consultation/wellness plan during my yearly physical even if my insurance doesn't want to pay for it)
-when I need a referral to a specialist, or coordination of care, my doctor picks up the phone and schedules the appointment for me with people he knows and trusts. There is then seamless coordination, my doctor has conveyed information better than I could AND I usually get in much sooner. I would bet anybody would benefit from this.
-I have a relationship with my doctor from longer visits and I feel more comfortable with him than I ever felt with a doctor I saw for brief, formal encounters. He actually has his head around my life and what's going on with me and I feel like he cares. I think that's really essential, actually, especially if you're dealing with depression.

Can't help you with Boston/Cambridge. There is a conceirge medical practice here that is cheaper that sounds a lot like One Medical -- it's not the same thing as having one doctor who limits his practice to just 200 patients and gives a lot of attention. I considered both and decided I wanted to build a relationship with just one doctor, not a clinic.
posted by sweltering at 10:53 AM on January 31, 2013

I've also had a really good experience with One Medical here in San Francisco, and so have several of my friends. I've worked with several doctors and they all really took time to listen to me describe the symptoms, and referred me to some really excellent specialists who were a perfect fit with my exact issue.

The other big thing is that their office is really easy to deal with for stuff like scheduling appointments or dealing with billing issues. It takes a ton of the stress out of getting appropriate medical care to be working with friendly people who seem really committed to helping you to navigate a sometimes frustrating process.
posted by psycheslamp at 12:14 PM on January 31, 2013

Marino Center. It isn't a concierge practice, but it has all the things you want. They take most insurances.
posted by Sidhedevil at 2:29 PM on January 31, 2013

Response by poster: Thanks everyone for sharing your experiences! Sidhedevil: thanks for the alternative suggestion. That place looks really promising.
posted by Calicatt at 2:52 PM on January 31, 2013

I go to a clinic place like this, and I can't recommend it enough. Lots of specialists in house, lots of generalists in house, right across the street from a hospital, etc. If you need a bone set, you just walk over to the orthopedic guy. If you need blood tests, you walk over to the lab and they do it.

It is how medicine should be practiced in this day and age. It isn't concierge, but I'd pay it if they asked. This sounds like a good place.
posted by gjc at 4:16 PM on January 31, 2013

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