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I would totally consider this for our kids' pediatrician.

@mrbee: really? I mean, you don't already get these services at your ped's office? If your kid has ear pain, for example, do they not have a service where you can be seen that day?

No!

Both me and my kids can usually get same day sick appts and when I have needed outpatient care it happens within 5 days - doesn't seem worth it to me!

Is this in addition to your insurance or is this for people w/o insurance?

@Mrs. Lemon-Lime: I would definitely not do it then. Going to the doc in the box every time I got sick would be cheaper!

@Mrs. Lemon-Lime: then no way! I would find a new doctor!

@looch: I figured that stuff like telephone appointments and Skype consults might also be covered? I'd be interested in paying a flat rate for more access.

@Mrs. Lemon-Lime: Absolutely not. I thought concierge/"boutique" practices usually operated without accepting insurance! It sounds like you would just be paying for a somewhat exclusive relationship with this provider and a "fast-track" to care, which under most circumstances, you wouldn't need.

@mrbee: Do you not get phone consults with your Ped? We have a nurses line that I call ALL THE TIME for free!

I would not - we hardly ever go to the Dr (yet... we'll see where more kids get us, and how they age... haha), and all the offices we use aren't too crowded as it is, I've never had a problem when/if I needed to get an appointment

I just read about this in our state, because I hadn't heard of it before. It isn't something I'd do, but it was interesting to learn that here its mostly older patients who choose this kind of service. They have several health issues, and want lengthy sessions with their Doc to talk about preventative practices. Doctors in private practice typically get paid "fee for service" so they are going to make the same amount if they meet with you to chat about your diet for 15 minutes or if they meet with you for an hour. This, coupled with low reimbursement rates from medicaid, means they have to book more patients than is preferable in order to make ends meet. Its an unfortunate consequence of the structure of our healthcare system / insurance reimbursement. Its why specialists make so much more money than primary care physicians, and why there is a shortage of primary care physicians (they all have the same student loan debt, and PCP docs work longer hours!).
The article I read talked with two doctors in our state who practice in this way, and offer home visits as part of the package, which is appealing to older patients (and parents of babies with health issues).

Honestly, its just another example of how broken our health care system is, and how desperately we need some changes.

My husband is going into primary care (pediatrics) and we are often frustrated by his options- significantly less pay than specialists, for longer hours and more call. I heard an NPR story yesterday about places where "free surgery" clinics are being opened for under/un-insured people to help address issues before they end up in the ED. So doctors are being asked to volunteer their time on Sundays to perform free surgeries so that the hospitals don't have to take on the costs when people end up in the ED with issues that could have been more easily/cheaply addressed months ago. I would be seriously pissed if someone asked me to do my job for free. I mean, its wonderful that some people are willing to do it....but what a broken system!

ETA: the article I read was pre- ACA. I'm not sure how the ACA impacts this?

I would find another doctor.

My dad uses a concierge physician. He has a number of complicated medical conditions and his doctor consults with all of his different specialists and develops a treatment plan that works. His doc will take calls 24 hours, texts results, arranges for special care if my dad gets sick out of town.

It's actually a really valuable service for him. I wouldn't do it for myself because I don't have any health issues now but down the road I'd consider it if something came up.

This would not work for us, but I can see how it is important and valuable for others.

My PCP sent a similar letter a couple years ago. I did not choose to participate.

But I also rarely go there. I go to my ENT a lot more often because I mostly get sick with sinus infections. On the rare occasion I go to my PCP, I've still been able to get in with no problem, so you might just wait and see how this "plan" is accepted at the practice and whether or not it impacts your coverage.

My mom's doctor is doing this. I don't think it's connected to the ACA for him, though. He's super popular and wanting to slow down a bit to devote more time to research and other projects. So he's taking on a smaller number of clients with a similar yearly fee. My mom isn't doing it. She likes one of the other doctors in the practice so she's just going to see her all the time now.

I kind of think it makes sense from a business perspective. Doctors only have a small amount of time to devote to patient care and they want to make sure they're serving the people that need them the most (in theory).

What makes me uncomfortable about the practice is that it is only available to someone that can afford the yearly fee. If you are wealthy and sick, fine, but if you are poor and sick, then you're out of luck.