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How Affordable Concierge Medicine is Changing Healthcare · Doctor Turned Health Coach

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  Today, we're going to talk about concierge medicine. What is a concierge doctor?
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  Now, the word concierge, of course, is going to make us think,
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  oh, this is some fancy dude who's going to charge me a ton of money.
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  But look, the reality is there's a whole spectrum of concierge doctors.
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  But concierge medicine, this term came about because the mainstream current
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  healthcare system that most of us are a part of is the health insurance system.
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  We pay our money directly to an insurance company or sometimes our employer
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  pays the money directly to an insurance company.
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  That insurance company then gets to decide what healthcare access we have,
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  what healthcare services that we're going to get.
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  And we will do what we can. We end up calling many people. Hey,
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  how can I get this appointment?
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  You had to wait on the line just to be able to talk to a nurse who will then
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  book you an appointment and you go to the doctor's office and you got to wait forever.
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  It's frustrating. And once you get to the doctor's appointment,
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  of course, you only have a few minutes.
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  When you get the prescription, you go to the pharmacy and all of a sudden you
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  realize this is a ridiculous amount of money to pay for this medication.
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  And did I even really need this medicine?
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  I didn't even get a chance to talk to the doctor as to whether I need this medicine or not.
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  All of these things have led to quite a lot of frustration in the modern healthcare system.
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  Now, fortunately, God forbid any one of us has a major health disaster.
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  We get hit by a truck, we develop serious infections, we get cancer, we get a heart attack.
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  Look, there is no better place than our current modern healthcare system,
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  than what we have in the U.S.,
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  to go in, get immediate care, and get us back on track.
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  We've mastered that art. We've got that down. And fortunately,
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  your insurance will always pay for those things.
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  Concierge medicine came about because we needed to bridge this gap where somebody's
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  just getting this intermittent care, nobody's really listening to them,
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  and there's a lot of frustration, and overall their health is not really getting any better.
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  They're essentially just waiting to get the heart attack. But nobody's really
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  paying attention to that. Nobody's helping them with their habits.
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  What to eat, how much exercise to do, how to manage stress, how to build good
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  habits, how to get better sleep, right?
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  How to do resistance training for better bone health.
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  We don't want to all just wait until our bone is so osteoporotic that we end
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  up having to be on bone medication, right? I mean, osteoporosis medications.
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  So concierge medicine narrows that gap.
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  It helps you get better access, better care, longer appointments, deeper discussions.
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  And usually it goes without say that the kind of physicians who are going to
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  go into concierge medicine are physicians who are just a little bit more patient.
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  They're a little bit kinder. They have a little bit more empathy.
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  If you don't have those skills, you would never make it in the concierge world,
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  right? So what is the cost of concierge medicine and how does it work?
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  Well, there is the insurance-based concierge care, and then there's the cash-based
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  concierge care. That's the way I would divide it up.
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  In the insurance-based concierge care, you still have your health insurance. Usually it's a PPO.
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  You can't do an HMO because I, as a doctor, have to be able to accept your insurance.
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  Most HMOs are very restrictive.
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  Of course there's a ppo ipa hmo there's
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  all medicare advantage there's all sorts but it's
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  usually a ppo and the doctor says look i'll bill
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  everything to your insurance so you're responsible for that but you're also
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  going to pay me a certain amount every year to be part of my practice what this
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  allows me to do because the insurance reimbursement is usually very low per
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  patient so the doctor is often forced to see many, many patients per hour.
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  The doctor can now charge each patient a certain amount every month or every
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  year. Usually it's every year.
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  And they'll still bill the insurance. You get your medications through the insurance,
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  all of that. But now they can have a smaller panel.
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  Now, the reality is the doctor is still probably going to only spend about 20,
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  maybe 25 minutes with you. You're not going to get one-hour appointments.
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  And this annual fee is somewhere around $500, and it can be, of course, a lot higher.
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  There are certain concierge practices, these insurance-based concierge practices,
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  that charge $100,000, $150,000 a year.
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  Now, why is that? Is it because the doctor is that much better?
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  Unlikely, but that doctor's practice probably has a lot of resources for the patient.
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  They have an in-house cardiologist, they have an in-house nutritionist,
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  they have an in-house rehabilitation expert, they have an in-house mental health
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  expert, you name it, right?
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  They can offer those extra things. Now, the question is, does that really move the needle that much?
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  Probably not, right? Because health intervention is only effective up to a certain amount.
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  You can have fiber. Once you go over 70 grams of fiber a day,
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  you're probably just going to get diarrhea.
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  You're not going to get any healthier, right? Once your cholesterol is below
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  50, your LDL-C is below 50, you're not going to deposit any plaque in your arteries.
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  But you're not going to be any healthier, right? So it's only a certain amount.
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  Now, okay, so we got the insurance one, and we're going to talk about the cash-based concierge model.
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  The cash-based concierge model is what I do.
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  It's what direct care doctors do, direct care specialists or direct primary care doctors.
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  And the whole point of this is I contract directly with a patient.
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  My medical practice, that's online, takes patients from California where I'm licensed.
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  Unfortunately, in the U.S., we can only practice in the states that we have a license in.
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  And to obtain licenses in other states is very complicated. It's very expensive.
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  And yeah, there's a lot of rules and hoops to jump through. So I have a state
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  medical license in California.
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  And if somebody wants to be part of my practice, I charge them around $150 a month.
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  I don't take any insurance. And that's intentional because I don't want the
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  insurance company telling me what I can and can't do with the patient because
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  the concierge insurance doctor
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  still can only prescribe the medicine that's in that insurance plan.
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  They can only order the tests that that insurance company allows and,
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  well, many other limitations.
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  Me, on the other hand, somebody comes to me, whether they have or don't have
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  health insurance is of no relevance.
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  I will charge them 150 a month and they
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  have unlimited access to me no matter where they
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  go in the world no matter what happens no matter where they move in the world
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  move to in the world they will always have their primary care doctor if they
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  lose their job if they lose their health insurance if their health insurance
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  changes if the whole laws of health insurance change I will always be this patient's
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  primary care doctor I will get to know them.
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  And for a very small fee, even though it's a concierge practice,
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  this person gets access to me in a way that I don't think we just are accustomed to in the U.S.
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  Healthcare system. My appointments are one hour long.
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  We have unlimited conversations over text, over email.
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  We share information with each other. If they get admitted to the hospital,
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  even in a concierge practice, it's unlikely that that doctor is going to go
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  visit that patient in the hospital.
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  But guess what? if I'm local, if I'm nearby, I will do that.
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  Now, my practice is online. And I think the advantage of an online medical practice
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  is that it takes away the complexities and hurdles of getting care.
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  You always have your doctor just a phone call and a text away, right?
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  That to me is pretty important. That's how I have my own doctor is online.
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  My own doctor is a direct primary care doctor is a concierge doctor,
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  and she charges me $100 a month.
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  And she even has a physical practice in Irvine, California, but I really never go in person.
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  So I hope I gave you an idea of what concierge medicine is, how it's divided up.
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  And yeah, if you have any comments, please email me hello at drrashori.com.
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  You can find out more information in the show descriptions if you're interested
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  in this model, if you are looking for a primary care doctor or if you have a
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  friend or family member who's looking for their own concierge doctor,
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  well, please reach out to me.