“The best interest of the patient is the only interest to be considered.”
As many of you know this quote from William Mayo is my touchstone for how I conduct my practice. As more and more physicians are employed rather than independent professionals, the needs of the patient can take a back seat.
Physicians employed by a hospital may be under subtle pressure to direct patients to that hospital’s specialists or services even if there are better quality or lower priced options outside the system.
Physicians may be given incentives to treat patients according to rules developed by insurance companies, not physician groups.
Relying on payments from patients rather than hospitals or insurance companies helps ensure that the interests of the patient stay central.
Easy access to your doctor
Currently, most primary care providers try to take on more patients than they can adequately serve and this will only worsen as time goes on. The average primary care physician has 2500-3000 patients. On average patients see a physician about three times a year (more for infants and older adults, less for young adults). Thus, 2500 patients may need 7500 visits in a year. Unfortunately, a physician who sees 25 patients a day (less than twenty minutes per patient for eight straight hours!) working 230 days a year can only provide 5750 visits and most have trouble seeing more than 5000 visits a year. Note this does not allow time for calling to discuss test results or doing paperwork. It’s not just bad luck that patients often can’t see their doctors or get a timely call about their test results; it’s a mathematical impossibility. Thus, you may often find you are seen by a less experienced colleague or by a nurse practitioner instead of your physician and the visit is often rushed.
With concierge care, the patient panel is limited to 1000. A panel this size might need 3000 visits a year but a physician working 230 days a year spending 30 minutes per visit on average (16 patients a day) could see 3680 visits a year, more than is needed so that same day or next day visits become the norm.