How do you like concierge medicine?

April 23, 2017 8:37 PM

Off and on I hear people talking about "concierge" medical service. Can anyone who has this tell me the pluses and minuses? Rough cost? Or even a specific recommendation in the Seattle (or Eastside) area?
posted by madmethods to Health & Fitness (18 answers total)

There's a base membership fee, usually several hundred dollars up to several thousand dollars. Then depending on the appointments and procedures you get, you basically have to pay everything else, which is difficult to estimate, but based on my limited understanding of medical costs for various procedures, definitely in the thousands, if not tens of thousands.

You basically get continuous access (same-day or next-day appointments; these docs are on call 'round the clock to address any health concerns you may have) to a physician and have the option to get all your appointments with different specialists scheduled at all in one go. CEOs and other high-level executives who don't have the time to entertain the back and forth of scheduling a bunch of appointments with different providers get an appointment itinerary made up for them. They spend a day or two once a year at the clinic and get everything done in one go. If you're traveling and have a medical emergency, they can put a doctor on a plane (even overseas) so you can be seen. So, yeah, it seems convenient.

It is also one way for medical institutions to subsidize the healthcare costs of their poorer patients. The entire concept of concierge medicine is not without controversy. From the healthcare provider side, I've heard that it takes a certain level of masochism to work in such a capacity, as patients can get quite demanding and garner some eye-rolls amongst the staff.
posted by gemutlichkeit at 9:17 PM on April 23, 2017 [2 favorites]

Might want to look into One Medical which provides a sorta concierge-y experience at a lower price point with less frills. They're just getting started in Seattle (offices open in the summer of this year) but I have Bay area friends who need a lot of medical care and are big fans.
posted by potrzebie at 9:38 PM on April 23, 2017 [5 favorites]

I use One Medical and love it. There is also a video chat feature on the app which I've used when I had pink eye and wanted to chat to a nurse and get prescriptions. Also I believe you can use any location once you are member, which is super convenient if you travel regularly to metropolitan cities.
posted by pando11 at 10:21 PM on April 23, 2017 [2 favorites]

Qliance Is good and is basically $80 a month
posted by O9scar at 10:49 PM on April 23, 2017

I've been using One Medical for about a year now in the SF Bay area. I love it. I have a BCBS PPO plan through my employer, and joined OM because I was getting really fed up in trying to find a doctor who could see me within a reasonable amount of time, and was also a short drive's distance from my work.

The membership fee is $149, but I googled for a coupon code and joined for $100. One Medical's docs are covered by my insurance, so in terms of copayments and whatnot, I'm still paying what I would normally pay on that end.

Here's why I like it:

-Electronic appointment system: all the logistics can be coordinated online. I can request appointments, referrals, prescription refills, email my primary a question, etc. online. If you don't like having to make a bunch of confidential phone calls during work hours, it's great.
-Electronic records: similar to above, everything is online, and the notification process is seamless. You don't have to call the lab to confirm if they've sent the results to the doc, and then call the doc to tell you what the results mean, and then ask the doc's staff to fax/email a copy to you.
-Clean, inviting lobbies with free coffee and other beverages. No strange smells, or irritating TV running nonstop.

Overall, 75% less of the hassle you normally associate with going to the doctor. I had to get referrals for 2 different specialists, and OM did all the legwork in calling the specialist, confirming they take my insurance, and then letting me know. OM also obtained copies of the results from the specialist, and placed them in my electronic file.

In terms of physician quality, YMMV, but I've had a great experience with mine. She didn't rush my appointment at all, was very thorough and gave me 3 refills for my medication.
posted by invisible ink at 10:50 PM on April 23, 2017 [6 favorites]

Also, the membership fee may be lower for your area.
posted by invisible ink at 10:56 PM on April 23, 2017

Another One Medical fan and member here for all the reasons listed above, plus they have a 24-nurse line staffed by nurse practitioners which (in NY at least) means you can get a prescription when you're too sick to go to the doctor. On preview, what pando said.

Also they have 15 min appointments and full length appointments which you can choose based on why you're going in, and I've never felt rushed through a visit.
posted by (Over) Thinking at 1:07 AM on April 24, 2017 [1 favorite]

I'm a former One Medical patient. I have a chronic illness (not at all rare but not super common) and my experience was that the OM physicians were just not experienced (or maybe motivated) enough to function as my PCP. In terms of "making things easy" (insurance, referrals, labs, etc), I still had to do just as much legwork with OM as I have with other medical practices. For example, a test result came back to them on a Friday morning that I needed for a specialist appointment on Monday, and the only way I was able to get it was through a series of multiple phone calls that ended in a West Coast office worker faxing the result (because my East Coast home office was closed, or unwilling to send faxes, by 2 PM).

I also found the OM physicians did not have as strong a network (again, or maybe motivation) as other PCPs I've had prior and since. When OM wanted to send me to a specialist, I was given a referral and told it would be about 6-8 weeks until I could get an appointment. I was so frustrated that I ended up calling my pre-OM PCP, who placed a doctor-to-doctor call and got me an appointment the same week.

Ultimately I think OM is great for people who are mostly healthy or who have very bread and butter health issues (e.g. hypertension, diabetes), but otherwise I wouldn't recommend it. It was a different story five years ago but nowadays it's easy to find a physician who offers many of the concierge-type services like online messaging and scheduling, especially among physicians associated with major medical centers, so I've been happy since I made the switch to someone more inclined to care for a relatively complex patient.
posted by telegraph at 2:49 AM on April 24, 2017 [8 favorites]

My late mother's physician was in a two-doctor concierge practice. He was a very nice man, and at best a so-so doctor. She liked the access, but he didn't do much to address her medical concerns.
posted by Dolley at 5:24 AM on April 24, 2017

My parents see a private practice MD who moved to concierge medicine about 5 years ago. They love it. One huge plus for them is that he answers emails - they have the comfort of having their medical questions answered by their doctor, not a nurse hotline or worse yet an insurance company call center. They're typically able to get same or next day appointments for urgent concerns. They both feel he's very through and is able to really sit and take the time to understand their concerns. I can't speak to price - we're in Kentucky and I'm sure it wouldn't be applicable to a bigger west coast city!
posted by pecanpies at 5:35 AM on April 24, 2017

The term I've heard for the no-frills concierge service is "direct primary care," so you might try that as a search term, too. (Here's a recent piece by NPR, for example, that talks about some pros and cons.)
posted by lazuli at 6:30 AM on April 24, 2017

I used One Medical in NYC and really liked it. I could always get an appointment right away in whatever office was most accessible for me. The staff was super responsive and helpful. I got all my test results emailed to me which was amazing. The waiting areas were really pleasant. Often testing could be done on site. One time I had a (totally unfounded) freak out over what I thought might be a heart attack the day before Thanksgiving and they gave me an appointment the same day.

Drawbacks- the practice seemed to attract mostly younger, less experienced docs - I assumed because the pay was lower - and I never really formed the kind of relationship with any of them that I sometimes do with a single primary care provider.

If was available in my current city, I'd sign up. The cost at the time was around 100 for the year.
posted by bunderful at 7:18 AM on April 24, 2017 [1 favorite]

(Meaning the membership fee. I might be off on that number, the current membership fee is $199).
posted by bunderful at 7:26 AM on April 24, 2017

The article I read three years ago about concierge medicine in TIME is now in their pay-to-read archive. But this newer article that is still free to read is not about CM, but it's related and very interesting.
posted by Fukiyama at 9:29 AM on April 24, 2017

My insurance is free, but garbage. One Medical makes it only semi-garbage by handling all the scheduling and billing correctly, on time, and without me having to make a phone call (I can just email them, thank goodness.) It's absolutely worth it.
posted by blnkfrnk at 10:36 AM on April 24, 2017

> -Electronic appointment system: all the logistics can be coordinated online. I can request appointments, referrals, prescription refills, email my primary a question, etc. online. If you don't like having to make a bunch of confidential phone calls during work hours, it's great.
-Electronic records: similar to above, everything is online, and the notification process is seamless. You don't have to call the lab to confirm if they've sent the results to the doc, and then call the doc to tell you what the results mean, and then ask the doc's staff to fax/email a copy to you.
-Clean, inviting lobbies with free coffee and other beverages. No strange smells, or irritating TV running nonstop

Since the Asker is in the Seattle area, I want to mention that I get all that (except the free coffee) at the Polyclinic Northgate.
posted by The corpse in the library at 11:39 AM on April 24, 2017

You're in Qliance's service area. The website has information. I liked it, but didn't use it enough and I'm cheap.
posted by flimflam at 12:15 PM on April 24, 2017

Ha! I was just going to suggest Polyclinic Northgate as well. When I lived in DC I came very close to joining One Medical Group in order to get something close to the level of care I get at the Polyclinic Northgate. I never have to wait longer than 24 hours for an appointment, everything is clean and nice, and the staff is wonderful.
posted by lunasol at 10:29 PM on April 24, 2017 [1 favorite]