Under the hybrid model, physicians do not have to "fire" their patients. In fact, the additional economic support enables physicians to remain in plans that they otherwise might have to leave. Physicians can move to a hybrid model when as few as 5% of their patients opt to participate.
This level allows physicians to have a more meaningful office visit with their concierge patients. In medical school, physicians learn that 80-90% of a patient's diagnosis is tied to family and social history. Yet with an average office visit of 7.5 minutes, it's difficult, if not impossible, to fully gather all of this important information.
Because physicians can see fewer patients in a day and have more time for office visits with all scheduled patients, concierge models allow physicians to return to the way they were taught to practice medicine. They can take the time to thoroughly discuss family and personal histories. There is more time to be an advisor and advocate and to help insure a complete understanding of the medical, physical, and perhaps emotional situation that a patient is dealing with.
In short, it enables an element of advocacy and education as the ability to focus on preventive measures and plans for long-term health. No matter how dedicated or committed, those are simply services most primary care physicians can no longer provide during the average routine office visit of today.
Rewarded for Excellence
In fact, it is the opportunity to get to know patients and provide more meaningful counsel and care that has many physicians so invigorated by a concierge option. Indeed, physicians that now practice a hybrid model frequently comment that they had forgotten how much they missed talking with patients and that they are much better physicians when they have the appropriate amount of time to spend with each patient.
Physicians also appreciate the fact that with a hybrid model, not only can they continue to see patients, but the compensation mechanism of a concierge model allows them to be rewarded for excellence. Quality physicians, who are committed to providing outstanding personalized care, will see their practices thrive. Those that provide sub-par service will be unable to keep and attract the patients necessary to offer a viable practice.
In essence, that is with the hybrid model is about: a combination of socially responsible medicine and a private pay system that rewards excellence and strong patient relationships.
Let the Debate Continue
The debate on both how to "fix" the nation's current healthcare system and how to attract and retain primary care physicians is far from over. As discussions continue, we need to focus on the solutions that are viable, possible, and preferable. We would all like to have the prototypical Norman Rockwell style of medicine. However, realistically no one—not government, business nor individuals—is prepared to increase payment to a level that will achieve this level of care.
The hybrid concierge model represents a viable solution—one worthy of discussion in an honest debate. It accomplishes the following:
- Introduces a private source of revenue that can help to supplement a physician's practice
- Gives patients real choices in the type of care they receive
- Enables physicians the opportunity to practice
- Strengthens the physician/patient bond
This model provides the value that both patients and physicians want. It is one that can help to attract quality and caring physicians to the practice of primary care.
Is the hybrid model the only answer? Will it solve all the problems facing the primary care system today? No. But a growing number of players in the system believe that in order to maintain a healthcare model where physicians and patients are at the center of the care paradigm, the hybrid option must be included in the discussion of solutions.
Wayne Lipton is a managing partner with Concierge Choice Physicians, a private company developing hybrid model concierge practices for physicians in 11 states—California, Arizona, New York, New Jersey, Nevada, Delaware, Virginia, Massachusetts, Texas, Maryland and Florida. For additional information, contact Lipton at firstname.lastname@example.org or visit www.choice.md.