internal medicine group :: Article CreatorWhat's Concierge Medicine? Is It Worth It?
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Concierge medicine, a business model in which patients pay a membership fee to have a direct relationship with a doctor — used to feel like something just for the well-to-do. But as fees have come down and frustration with traditional primary care has gone up, concierge services are getting more attention.
My primary care doctor recently left her practice and invited me to join her at her new gig — a concierge medicine group. There, for a membership fee, I'd have better and more personal access to her services: same-day appointments and long conversations!
Concierge medicine — a model in which patients pay a membership fee for a more direct relationship with a primary care doctor — used to feel like a perk for the superwealthy. But as fees have come down and people have gotten more frustrated with the state of traditional primary care, concierge services may not seem like such a pie-in-the-sky option. There's less waiting, more access, longer visits and greater coordination of care. However, the fees can be high, and if you don't have complex medical needs, it may not feel worth the expense.
What is it?
Concierge medicine is an arrangement in which a patient pays a membership fee to gain access to a doctor's practice. Your fee may cover a wide range of services, with insurance covering any needs you have outside the practice, or your fee may cover basic preventive care and the practice might accept insurance for the rest.
But your experience, overall, is more personal. Concierge medicine typically offers same-day appointments and 24/7 access to your doctor (who, by the way, isn't rushed during visits).
Patients like it because they have more time with their provider, says Terry Bauer, CEO of Specialdocs, a company that helps doctors transition to concierge medicine. People with a medical situation after hours can call, text or email. "They have that doctor, in essence, on speed dial," Bauer says. "It makes people a lot more comfortable and a lot less anxious."
How much?
Membership fees for concierge medicine vary widely. For one large concierge network with doctors in 44 states , the fee is typically between $1,800 and $2,200 per year (or between $150 and $183 per month). Other practices can run much more.
"I know a couple that charge $4,000 a month," Bauer says. Doctors who charge those prices may be board certified in two specialties — cardiology and internal medicine, for instance — or they may be in an extremely wealthy area of the country, he says.
The good news is that if you have a flexible spending or health savings account, you can use those funds to pay your annual membership fees as long as they go toward wellness benefits.
Advantages
There's plenty to like about concierge medicine. It's usually possible to get same-day or next-day appointments with your doctor, and wait times are minimal, says Bret Jorgensen, chairman and CEO of MDVIP, a network of concierge medicine physicians. Typically, you have access to your provider at all hours of the day, and because they have fewer patients, your doctor has more time to spend with you.
"With a smaller patient roster, your doctor can take the time to know you and your health history intimately, which can lead to more personalized and effective care," says Dr. Shoshana Ungerleider , a practicing internal medicine physician and host of the TED Health podcast. "Concierge doctors can focus more on preventative care, which could potentially catch health issues early and save costs in the long run."
Disadvantages
The biggest stumbling block for most people is the price tag. "For people on a tight budget or those without substantial health care needs, this could be a significant cost without enough perceived benefit," Ungerleider says.
On top of the cost, there are practical concerns: Concierge doctors are still a small percentage of the medical field, so your options for care may be limited. And while a concierge doctor can manage your regular or chronic concerns, you'll still pay for visits to the hospital or emergency room, major surgeries and visits to other specialists.
"It does not negate the need for health insurance," says John Hansbrough, an employee benefits consultant with The LBL Group, an insurance and financial services company. "You need the insurance because bad stuff can still happen."
Advocates argue that concierge preventive care can save you money overall. Consider the scenario where a text exchange with your doctor saves you a 2 a.M. Trip to the emergency room, Jorgensen says. "More than 80% of our interactions with our members are virtual," he says. "Those are just bundled and included in the service."
Concierge medicine isn't a slam-dunk for everyone. If you can't afford the membership fee or are an infrequent health care user, this model probably isn't a good fit.
But it can be a game changer for patients with chronic illnesses who would benefit from the higher level of care. And for people who are frustrated by the conventional medical system, concierge care offers an alternative.
"There are great outcomes for the doctor and patient alike," Jorgensen says. "We consistently renew in excess of 90% of our patients every year."
UW Medicine Tasked With 'magic Mushroom' Research For Mental Health Therapy: HealthLink
UW Medicine tasked with 'magic mushroom' research for mental health therapy: HealthLink
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Newly passed legislation in Washington aims to further explore the power of psychedelic mushrooms as a tool for psychotherapy.
The University of Washington has the go-ahead to conduct a research trial using psilocybin, the compound found in what's commonly known as "magic mushrooms," to see if it can effectively and safely be used to treat mental health conditions.
The use of psilocybin in Washington is still illegal in the state, but on May 9, Gov. Jay Inslee signed legislation that enacts a state task force to further study it and lay the groundwork for a long-term strategic plan.
The bill, known as SB 5263, also authorizes UW Medicine to launch a pilot program to safely access and study psilocybin.
Dr. Nathan Sackett, an addiction psychiatrist and a professor at UW Medicine's Department of Psychiatry and Behavioral Sciences, is leading the pilot project that will help the state task force develop and better understand psilocybin as a potential mechanism for mental health treatment.
"Which is really a way to help address questions around safety and efficacy for patient populations that are typically not studied," Sackett said.
Sackett is particularly interested in how psilocybin therapy could help people who grapple with two disorders at the same time, such as post-traumatic stress disorder and alcohol use disorder.
"If we can give them this treatment safely, then perhaps it can provide more confidence that we can give it safely to a larger patient population," Sackett said.
While magic mushrooms have been decriminalized in Oregon and Colorado in recent years, lawmakers in Washington state say more needs to be learned.
"If they're going to get into the role of potentially widening access, we want to make sure it's safe for all people involved," Sackett said.
The research will look into how the psychedelic compound in psilocybin interacts with brain chemistry.
Sackett explained that when one ingests magic mushrooms, the compound that has the most psychoactive effects is psilocin, and psilocin enters the brain and acts on serotonin receptors.
Serotonin is the brain chemical that regulates multiple bodily functions, including mood. Sackett's team will study how psilocybin interacts with the part of the limbic system that handles emotion and the frontal cortex of the brain that handles reasoning and intellect.
"It alters the communication between those two parts and gives us the opportunity to reevaluate our own internal narrative if you will," Sackett said.
However, Sackett does not recommend people take magic mushrooms on their own, even for therapeutic reasons, without licensed supervision.
"The main therapeutic benefit comes in a controlled environment where you have the relationship with the therapist and someone who can help make meaning to the experience," Sackett said.
Sackett adds he wants to advance the science behind this potential treatment.
"I think we're at a point where we are in desperate need for more treatments for folks struggling with mental health concerns and substance use disorders. I'm hopeful this sort of work will move the needle in that direction and give us more tools to work with, with patients moving forward," Sackett said.
The UW Medicine trial will begin on January 2025.
Sackett and his team will initially include 30 to 40 people, namely, military veterans and first responders, who have documented experience with PTSD and alcohol use disorder.
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