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Wouldn't it be nice if your doctor always gave you an appointment when you wanted to be seen, no waiting, no need for preapproval from your insurance company? it costs a little extra, but that's exactly what you can get with a concierge doctor.

Doctors don't get a lot of sympathy when they talk about their financial woes, the average internist in the United States earns $210,000 a year, after all, but the continuing squeeze from Medicare and insurance companies have caused some to reconsider how they want to organize their practices. 

A procedure that once was reimbursed with several thousand dollars, a colonoscopy, for instance, now just gets a check for a few hundred from the insurance company. Some office visits only bring in $20 or $30. The costs of keeping the office open, however, continue to rise, and the costs of keeping up with technological advances and fending off malpractice lawyers are staggering.

Some doctors, starting in the higher-cost, wealthier parts of the USA such as Manhattan and Beverly Hills, have come up with a different way to run their practices that both they and their wealthier clients enjoy, concierge medicine.

What Is Concierge Medicine?

In a concierge practice, the doctor quits taking insurance and starts charging patients a fixed, annual fee. For $1,000 to $5,000 per year, and often even less, the patient gets any of the doctor's services for no additional charge, and usually with very little waiting. The doctor can budget his income and expenses for the year, and the patient doesn't have to worry about insurance preapproval, copays, or limitations on the types of procedures the doctor can perform.

Why Would I Possibly Prefer a Concierge Doctor?

There really are doctors who practice medicine for the love of the challenge, or for the personal satisfaction of helping people, or for the prestige of the profession. There probably aren't many doctors who practice medicine because they are enthused that they might have $3 left over after paying overhead, office salaries, and taxes for a brief office visit. 

Doctors still do quite well financially, but the system is set up so that they earn vastly more for complicated medical issues than for simple medical issues. They earn more for treatment than prevention. If you want a doctor to focus on what's good for you rather than what builds up his bottom line, you may prefer to see a concierge practitioner if you can afford it.

But Aren't Concierge Doctors Just for Rich People?

Concierge medicine is no longer an idea confined to the wealthier urban areas of the United States. Even in places like Jackson, Mississippi and San Antonio, Texas, there are doctors who charge a flat annual fee for their office services, sometimes as little as $150 to $200 a year.

On the other hand, there are also concierge services like that of Dr. Edward Goldberg and Dr. Daniel Yadegar of New York City who charge 400 patients $25,000 a year for truly unfettered access to medical care. Concerned that you might have a heart attack on your yacht when you sail around Tahiti? The doctors are only too happy to provide a doctor to sail with you. Need someone to hold your hand, or in one instance, your toe, when you are in an MRI machine. Your concierge doctor is at your service. Of course, with the practice bringing in $10,000,000 per year, maybe your doctor doesn't mind.

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