Why More Vermont Physicians Are Making the Switch to “Concierge” Practices

Some key quotes from this week’s issue of Seven Days (a local weekly):

The 59-year-old family practitioner says he was driven more by a desire to regain his “autonomy” as a physician and get back to the basics of why he got into medicine 27 years ago.

“I enjoy caring for my patients, which means being available to them and on call when they’re in trouble or have questions, and I don’t want them to be limited to a 15-minute visit,” she adds. 

Local concierge doctors such as Cunningham say they’re treating a broad demographic of patients and medical conditions. Equally important, she says they’re doing something the Affordable Care Act, and the insurance companies, have yet to accomplish: They’re increasing the quality of care their patients receive while simultaneously controlling costs.

A five-year study of “personalized preventive care,” published last year in the American Journal of Managed Care found significant reductions in patient hospitalizations, elective and nonelective surgeries, and unavoidable admissions. For some patients, especially those on Medicare, the rates were nearly 80 percent lower than those not receiving “managed care.”

I didn’t bother to quote some of the classic objections (“…it’s only for the rich!”), I’m just glad to see a glimmer of understanding that this a viable and sustainable method for providing some medical care.

2 replies
  1. Robin
    Robin says:

    On the same topic, I read this yesterday from Yahoo:


    “On the other, pared-down clinics charge roughly $50 to $100 a month for basic primary-care medicine, more accessible doctors, and yes, money savings for those looking to reduce their health spending.

    Of the estimated 5,500 concierge practices nationwide, about two-thirds charge less than $135 a month on average, up from 49% three years ago, according to Concierge Medicine Today, a trade publication that also runs a research collective for the industry. Inexpensive practices are driving growth in concierge medicine, which is adding offices at a rate of about 25% a year, says the American Academy of Private Physicians.

    Unlike high-end concierge practices, which typically bill insurers for medical services on top of collecting retainer fees, the lower-end outfits usually don’t accept insurance. Instead, they charge patients directly for treatment along with membership, often posting menu-style prices for services and requiring payment up front, which is why it is called “direct primary care.” Eliminating insurance billing cuts 40% of the practices’ overhead expenses, enabling them to keep fees low, doctors say.

    On the cusp of the Affordable Care Act mandating most Americans to have health insurance next year, a rise in doctors who don’t take insurance might seem paradoxical. But health-care experts say the two forces go hand in hand, as patients may find concierge doctors more accessible, especially if traditional doctors get flooded with more patients. Also fueling the trend is a little-known clause tucked into the health-care law that allows direct primary-care to count as ACA-compliant insurance, as long as it is bundled with a “wraparound” catastrophic medical policy to cover emergencies.”


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