tag:blogger.com,1999:blog-1350181109033523476.post6027714522610768201..comments2023-08-24T00:28:08.108-07:00Comments on Why is American health care so expensive?: the $25 planJanice Boughtonhttp://www.blogger.com/profile/02321947802871503562noreply@blogger.comBlogger2125tag:blogger.com,1999:blog-1350181109033523476.post-19485566432208649172010-01-05T13:15:14.048-08:002010-01-05T13:15:14.048-08:00Why is American HC so expensive?
I'll speak to...Why is American HC so expensive?<br />I'll speak to primary care....<br /><br />The problem: Fee For Service<br /><br />Innovative ideas for change to a direct practice (direct financial relationships with our patients) by physicians are important to change primary care business models. <br /><br />My thought on your mixed model:<br />- You are worth more than you are charging. You may be suffering from the Mother Theresa Syndrome, a common malady many of us have where we don't mind offering our services for a discounted price or free.<br />- If patients trust and like you, they will gladly pay a reasonable amount of money to have easy access to their trusted physician (quality, access, cost) The patient determines the value of the service in their own marketplace.<br /><br />You suggest a mixed model (fee for care {$100/year} AND fee for service {$25/visit}.<br /><br /> Problems: <br /> a. You have more bookkeeping with FFS {a daily issue} and you have to trust your staff for collections. This will take up lots of your personal time doing bookkeeping.<br /> b. If you are not seeing patients, then you are not collecting revenues. Your monthly revenues will vary.<br /> c. Patients do not want to come in to wait and would rather be treated over the phone if possible or they just have a simple question.<br />In other words, they want service. Your liability is virtually gone when you are treating your friend.<br /><br />In terms of "Concierge medicine", it is not for the rich only....Many of our patients don't even have jobs and they can afford it.....I have many scholarship patients and I trade chickens like the old days. Not surprisingly, many don't want a free ride.<br />They will come up with the money b/c for many of us, it's cheaper than cigarettes ($150-180, mo)...They have cell phones, cars, eat out....<br />They make the choice.<br />AVG price is $100-150/mo...with most having 4-600 patients.<br /><br />The real definition of a direct practice is the pure Fee For Care model....We don't accept insurance, Medicare nor Medicaid associations and we accept ALL patients. <br /><br />It's the best thing we have ever done.<br />These are QUALITY-driven practices, not VOLUME-driven practices....It's all about the operations and what your communities price point will bear. And don't be discouraged if the more wealthy don't sign up...It's not surprising that many, even in the close to poverty range, will value you enough to figure out how to raise the money for the services you provide. Many family members will pitch in if someone is in need....<br /><br />Make sure you look at all the models....Consider becoming a member of SIMPD (soon to be AAPP - American Academy of Private Physicians) www.simpd.org<br />We have "How to" courses to expand your knowledge about the models.<br />Consider a consultant to guide you through this. many mistakes are made in transition and it's good to have someone who has been there before.<br /><br />Chris Ewin, MD<br />past-president, Society for Innovative Medical Practice Design<br />www.121DrConsulting.com<br />cewin@121md.netChris Ewin, MDhttp://www.121drconsulting.comnoreply@blogger.comtag:blogger.com,1999:blog-1350181109033523476.post-2374623475561230042010-01-04T20:51:58.920-08:002010-01-04T20:51:58.920-08:00Good idea Janice - and in fact, at places like Qli...Good idea Janice - and in fact, at places like Qliance (http://www.qliance,com), their brand of "concierge medicine" offers a very affordable monthly fee and caters to the un- and under-insured in Seattle. Definitely not the stuff of wealthy folks. Dr Garrison Bliss should be leading the pack in primary care health reform. <br /><br />Nice to discover your blog! Good luck with your practice and healthcare musings :-)Philippa Kennealy MD MPH CPCC PCChttp://www.entrepreneurialmd.comnoreply@blogger.com