From the Baltimore Sun:
The physicians at Charter Internal Medicine in Columbia are overhauling the practice, ditching the insurance-dependent model and instead charging a flat yearlyfee in exchange for the promise of 24-hour access to doctors, unhurried appointments, home visits and state-of-the-art annual physicals.
Known as “boutique” medicine or “concierge” care, the national trend appears to be sweeping across Maryland as primary-care doctors feel the financial crush of rising costs and low insurance reimbursement rates. Physicians say the model allows them to trim their patient loads and give patients quality care without worrying whether insurance will cover it.
“Primary-care doctors are seeing 30 to 40 patients a day – that’s too many,” said Dr. Harry A. Oken, who has been with Charter Internal Medicine for more than 20 years. “It’s not about the money. It’s about having the time to spend with your patients to keep them healthy.” …
“Doctors have nowhere to turn but to try to find a different business model,” said Dr. Ronald Sroka, president of the medical society, known as MedChi. “Some people want more than their insurance company will provide, and some people are willing to pay for this additional service.”
Sroka, who practices in Crofton, said that after paying salaries and expenses, he makes about $15 to $20 an hour. He said he’s not sure if he can last more than another year or so, working some 80 hours a week to keep up with his bills.
Proponents say boutique practices allow doctors to increase their income while reducing hours and giving patients higher-quality care.
Insurance reimbursement rates for primary-care doctors are lower than for other specialties, Sroka and others point out. That, coupled with Maryland’s high cost of living, overhead and insurance premiums, has led many doctors to take on large patient loads to stay afloat. Some are leaving the business.
(Via the Galen Institute)
