This article last month in Crain’s New York Business talks about the pressures that primary care doctors are facing and how those financial pressures are getting many of them to try cash-only or concierge practices. Here’s an excerpt from the article:
To stave off the pressures prompting many physicians to sell their practices to hospital systems, Manhattan internist Peter Bruno has tried a number of creative solutions. They have ranged from forming a now-disbanded group practice with 60 colleagues to his ongoing strategy of working at a nursing home one day a week to supplement his income in his current solo practice.
With reimbursements dropping, Dr. Bruno made the bold move in July of converting his six-employee private practice on East 59th Street in Manhattan to a hybrid concierge model. In concierge care, patients pay an annual fee or retainer to get more immediate, customized care. Hybrid practices treat both concierge and traditional patients. He worked with SignatureMD, a Santa Monica, Calif.-based network that assists physicians in doing so.
I don’t think we need to cover the financial realities of being a solo physician here. You’re all to aware of the challenges. However, I’m interested to hear what you think about the potential for the concierge model of medicine for primary care doctors? Is that an option for most primary care doctors?
I ask this because I’ve seen concierge medicine work in the rich areas (the above case is Manhattan for example), but I have yet to see it really work in poorer areas. If we’re shifting to concierge medicine, what does that mean for the poorer areas of the country?
Here in Las Vegas, they have an interesting hybrid model that they’re trying where concierge medicine is part of the insurance plan. In fact, it could be part of the insurance plan your employer provides. I just signed up for the plan, so we’ll see how it goes.
I’m also watching how the EHR market is adapting to this trend as well. Over on EMR and HIPAA I wrote an article titled “An EHR Focused On Customer Requests, Not MU” which talks about what an EHR would look like that was just focused on patient care and how Amazing Charts was offering that product.
Just today SRSsoft announced their new SRS Essentials product that’s a non-MU EHR as well. Although, they offer an interesting wrinkle that allows their SRS Essentials customers to move up to an meaningful use certified EHR should they decide they later want to take part in meaningful use (or whatever that program eventually becomes).
Of course, SRSsoft focuses mostly on the specialty market and not general medicine. Although, maybe this physician focused EHR product will be of interest to the emerging concierge and direct primary care doctors as well.
What do you think of these new models of medicine? What’s their place in the healthcare world? Where are they going in the future? Will their technology needs be different than other doctors?