Concierge Physician Access

Concierge Physicians goes by many names, boutique medicine, retainer medicine, executive health, VIP medicine, and personalized medicine. By any name, Concierge Physician is the solution for doctors trying to maintain their integrity and independence in today’s difficult healthcare environment. Concierge Physician is a new style of practice with old roots, in which doctors limit their patient base in order to provide patients with personalized service, high quality care, 24-7 availability, and other amenities. In exchange for this enhanced personal attention, patients pay physicians an annual fee. This concierge fee enables physicians to increase their compensation while managing their workload. In addition to receiving an annual fee, most concierge physicians continue to receive reimbursements from health plans and private pay clients. Concierge Physicians is a relationship between a patient and a primary care physician in which the patient pays an annual fee or retainer. This may or may not be in addition to other charges. In exchange for the retainer, doctors provide enhanced care. Other terms in use include boutique medicine, retainer-based medicine, and innovative medical practice design. The practice is also referred to as membership medicine, concierge health care, cash only practice, direct care, direct primary care, and direct practice medicine. While all Concierge Physicians practices share similarities, they vary widely in their structure, payment requirements, and form of operation. In particular, they differ in the level of service provided and the amount of the fee charged. There are an estimated 5,000 concierge, or membership medicine doctors throughout the U.S. Concierge physicians care for fewer patients than in a conventional practice. All generally claim to be accessible via cell phone or email at any time of day or night or offer some other special service beyond the normal care provided. The annual fees vary widely, from $600 to $5,000 per year for an individual, with the lower annual fees being in addition to the usual fees for each service and the higher annual fees including most services. Some concierge practices do not accept insurance of any kind. These are as cash-only or direct primary care practices. By refusing to deal with insurance companies, these practices can keep overhead and administrative costs low, thereby providing affordable healthcare to patients. They become concierge only if the practice assesses an annual or monthly fee instead of or in addition to a fee for each medical service. Other concierge practices do take insurance, even Medicare, but ask for an annual fee for additional services exclusive of insurance plans. This annual fee is not a substitute for medical insurance, and generally does not cover consultations outside the practice, laboratory procedures, medicines, hospitalizations, or emergency care from other providers.

House Call Doctor

A house call, or Physician house call, is an act of customer service where the doctors goes to the consumers home, rather than the consumer visiting the suppliers place of business. House calls are most often associated with doctor house calls. There are still doctors making house calls. The physician-led multidisciplinary team provides comprehensive, patient-centered care for any condition, from the simple problems to the very complex, in the patient’s own environment. Thanks to modern technology and our sophisticated, multi-faceted delivery system, we can do more tests and procedures in our patient’s home or place of business than other primary care physicians do in their office. House call doctors are equipped to perform most procedures normally performed in a medical office. House call doctors utilize electronic medical records and will coordinate home health and hospice services, mobile imaging services, durable medical equipment services, laboratory services, and specialist referral services. House call doctors acts as the primary care physician or as augmentation to or as an interim physician to the patients’ present medial team. Doctor’s House calls provide post hospital stabilization service to physicians, insurance plans, and hospitals to mitigate hospital re-admissions.

Personalized Medicine

Personalized medicine is a medical model emphasizing the systematic use of information about an individual patient to select or optimize that patient's preventative and therapeutic care. Personalized medicine is the products and services that leverage the science of genomics and proteomics and capitalize on the trends toward wellness and consumerism to enable tailored approaches to prevention and care. Over the past century, medical care has centered on standards of care based on epidemiological studies of large cohorts. Personalized medicine seeks to provide an objective basis for consideration of such individual differences. Traditionally, personalized medicine has been limited to the consideration of a patient's family history, social circumstances, environment, and behaviors in tailoring individual care.

Personalized medicine uses new methods of molecular analysis to manage a patient’s disease or predisposition toward a disease. It aims to achieve optimal medical outcomes by helping physicians and patients choose the disease management approaches likely to work best in the context of a patient’s genetic and environmental profile. Such approaches may include genetic screening programs that more precisely diagnose diseases and their sub-types, or help physicians select the type and dose of medication best suited to a certain group of patients.

Personalized medicine is an extension of traditional approaches to understanding and treating illness. Since the beginning of the study of medicine, physicians have employed evidence found through observation to make a diagnosis or to prescribe treatment. In the modern concept of personalized medicine, the tools provided to the physician are more precise, probing not just the obvious, such as a tumor on a mammogram or cells under a microscope, but the very molecular makeup of each patient. Looking at the patient on this level helps the physician get a profile of the patient’s genetic distinction, or mapping. By investigating this genetic mapping, medical professionals are then able to profile patients, and use the found information to plan a course of treatment that is much more in step with the way their body works. Genomic medicine and personalized medicine use genetic information to prevent or treat disease in adults or their children. Having a genetic map or a profile of a patient’s genetic variation can then guide the selection of drugs or treatment processes. This can minimize side effects or to create a strategy for a more successful outcome from the medical treatment. Helping the physician cover all the bases is imperative. Genetic mapping can also indicate the propensity to contract certain diseases before the patient actually shows recognizable symptoms, allowing the physician and patient to put together a plan for observation and prevention.

Personalized medicine, when coupled with personal pharmacogenetics, is a unique approach that may be well suited for the health challenges we face in the new millennium. Although the medical and scientific communities, through research and discovery, got the upper hand over many of the diseases we have encountered since the advent of advanced medicine, many diseases that are more complicated. Diseases like diabetes, heart disease, cancer, and Alzheimer’s are caused by a combination of genetic and other factors. Coupled with the fact that they tend to be chronic, they place a significant burden on not only the patient, but on the healthcare system as a whole. Personalized medicine aims to provide the tools and knowledge to fight chronic diseases and treat them more effectively than ever before. Genetic profiles can help physicians to better discern subgroups of patients with various forms of cancer, in addition to other complex diseases, helping to guide doctors with accurate forms of predictive medicine and preventative medicine. With personalized medicine, the physician is intending to select the best treatment protocol or even, in many cases, avoid passing the expense and risks of unnecessary medical treatments on to the patient altogether. In addition, personalized medicine, when used correctly, aims to guide tests that detect variation in the way individual patients metabolize various pharmaceuticals. Personalized medicine is working to help determine the right dose for a patient, helping to avoid hazards based on familial history, environmental influences, and genetic variation.

INVESTMENT INTERESTS

SEC. 6002. TRANSPARENCY REPORTS AND REPORTING OF PHYSICIAN
OWNERSHIP OR INVESTMENT INTERESTS.
Part A of title XI of the Social Security Act (42 U.S.C. 1301 et
seq.) is amended by inserting after section 1128F the following new
section:
  SEC. 1128G o42 U.S.C. 1320a–7h.. TRANSPARENCY REPORTS AND REPORTING
OF PHYSICIAN OWNERSHIP OR INVESTMENT INTERESTS.
(a) TRANSPARENCY REPORTS.—
(1) PAYMENTS OR OTHER TRANSFERS OF VALUE.—
(A) IN GENERAL.—On March 31, 2013, and on the
90th day of each calendar year beginning thereafter, any
applicable manufacturer that provides a payment or other
transfer of value to a covered recipient (or to an entity or
individual at the request of or designated on behalf of a
covered recipient), shall submit to the Secretary, in such
electronic form as the Secretary shall require, the following
information with respect to the preceding calendar
year:
(i) The name of the covered recipient.
(ii) The business address of the covered recipient
and, in the case of a covered recipient who is a physician,
the specialty and National Provider Identifier of
the covered recipient.
(iii) The amount of the payment or other transfer
of value.
(iv) The dates on which the payment or other
transfer of value was provided to the covered recipient.
(v) A description of the form of the payment or
other transfer of value, indicated (as appropriate for
all that apply) as—
(I) cash or a cash equivalent;
(II) in-kind items or services;
(III) stock, a stock option, or any other ownership
interest, dividend, profit, or other return on
investment; or
(IV) any other form of payment or other
transfer of value (as defined by the Secretary).
(vi) A description of the nature of the payment or
other transfer of value, indicated (as appropriate for
all that apply) as—
(I) consulting fees;
(II) compensation for services other than consulting;
(III) honoraria;
(IV) gift;
(V) entertainment;
(VI) food;
(VII) travel (including the specified destinations);
(VIII) education;
(IX) research;
(X) charitable contribution;
(XI) royalty or license;
(XII) current or prospective ownership or investment
interest;
(XIII) direct compensation for serving as faculty
or as a speaker for a medical education program;
(XIV) grant; or
(XV) any other nature of the payment or
other transfer of value (as defined by the Secretary).
(vii) If the payment or other transfer of value is
related to marketing, education, or research specific to
a covered drug, device, biological, or medical supply,
the name of that covered drug, device, biological, or
medical supply.
(viii) Any other categories of information regarding
the payment or other transfer of value the Secretary
determines appropriate.