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Physicians changing to concierge practice.

Posted: Jul 2, 2012

My daughter's doctor started a concierge practice, where he will see only certain patients who agree to pay thousands of dollars up front. She lives in Colorado.

Friends of mine from Pennsylvania said their doctor is doing the same thing.

Has anyone heard of any other physicians doing the same thing?

;

We have a doc you can pay with chickens and eggs - Sue Lowdown

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For some reason he isn't listed with AMA or HealthGrades, though.

We have another bizarre situation - Where docs are having "group" office vis

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Patients that have "similar" problems as determined by the healthcare guidelines, are seen in a group setting where your health cncerns are openly discussed in the group. The doctor heading up the group answers those question in the group. These "office vists" last approximately an hour. There is no exam, no personal exchange. The reasoning, when asked, is that this was instituted after Obamacare and health facilities were to get patients "comfortable" with the idea. The docs cannot afford to see each patient individually for $ 15.00 reimbursement approximately; so, they lump about 12 to 15 together for approximately $ 180 to $225.00. You are still going to have the Naive Nancies on here that refuse to believe that Obamacare is not harming healthcare. Can't wait to hear what they have to say about their "group office visit". In our state, this is being pushed hard for the VA to adapt this for our vets. Shows you what Obama thinks of our military.

the practice of concierge medicine predates Obama - fyi

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exempli gratia - sm

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http://www.nytimes.com/2005/10/30/health/30patient.html?pagewanted=all

"Since its debut in 1996, concierge medicine has evoked criticism from many corners. Some ethicists say it is exacerbating the inequities in American health care. Insurance regulators have raised concerns about fraud. Government watchdogs, worried that it threatens the tenuous equilibrium of the health care system, are keeping an eye on trends."

Concierge healthcare - ...

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"Concierge medicine (also known as direct care) is a relationship between a patient and a primary care physician in which the patient pays an annual fee or retainer.
en.wikipedia.org/wiki/Concierge_medicine - Cached.Cn"

The clinic I go to started doing this years ago. - I think group visits are CREEPY. nm

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Agreed - Conservative

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We have never had this in my area until very recently. So much for HIIPA and privacy in regards to your medical care. Whose to say where that information would end up, or who those in the group would decide to share that information with? The whole concept is very dehumanizing.

Please post a link--never heard of such a thing - thank you - nm

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Why did you reply to Conservative? - what if - sm

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She was not the person who originally wrote the message. Why didn't you reply to the poster who originally wrote this? Or even why didn't you ask that (to provide you with links) of the person Conservative replied to who said it was in her area too?

Since you are wanting a link:

http://www.aafp.org/online/en/home/practicemgt/quality/qitools/pracredesign/january05.html

http://www.ivanhoe.com/channels/p_channelstory.cfm?storyid=12041

http://www.aafp.org/fpm/2006/0100/p37.html

And those are the first three links on Google plenty more, but not posting them all. This is what we are talking about. If you read something on this board, instead of challenging a poster asking them to post links, why don't you open a Google and type it in and do some research.

Besides Conservative was agreeing with the two previous posters and said it was happening in her area "too", so why didn't you ask them to provide you links, why single out Conservative?

P.S. - No Conservative was not lying.

Thank you "what if:" - Conservative

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I saw your response. Since I do not respond to any "nm" or sm" posts, I had to go back and read all those posted above mine for the full content. I find it interesting that a complete stranger will take time to question my post and completely ignore their own ability to search the subject. If you could find the information, as did others, what was nm's handicap in using Google? I am sure it was for nothing more than to flame, as so many of the nm, sm posts are; exactly why I refuse to waste my time addressing them. Now back to the OT.

I use nm and sm as a moniker, and I thought your - sm

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post was very good. I marked it "like."

who cares - tulip

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Who cares if they replied to the OP or not? ***

I second that motion. - geez x2. nm

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I care. Just don't care too much for stalkers - what if - sm

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I want to know why posters are going after others. It's stalking, bordering on harassment. All I read is prove it, prove it, prove it. you said the sky was blue, prove it with a link. You gave your opinion on something prove it and make sure you provide a link from one of our approved lists.

I want to know why she singled out Conservative instead of asking the question to the OP who first talked about it. Why didn't ask them for links.

I want to know what is so hard about opening a Google to do your own research. I myself had never heard of group office visits. So the first thing I did was open a Google and typing in "group doctors visits". I also typed are doctors seeing patients in groups. Got a ton of links myself. I'd like to know why posters demand others posts links, and only certain posters.

And I don't like being bullied by posters telling me who cares. As though I'm not supposed to question anyone staling and calling other posters liars. I care. Maybe you should be the one to take a chill pill. Yeah, geez is right.

Unstable stalkers reveal themselves routinely - on this board

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Then scream victim when turned back on them. They would rather be a board bully then go and look up a fact,any fact. They are nothing more than a bunch of babies.

what if... - tlf

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It's quite likely the poster responded to Conservative by mistake. I certainly have seen this happen; I have done it once or twice myself. I don't think it's fair to assume that Conservative is being singled out, nor do I think it's reasonable to assume that one poster asking a question constitutes a pattern of stalking and harassment.

You mention that you "want to know why posters are going after others". I think that's a good question.

Apparently please and thank you translate to - stalking flamer in cons-speak

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An angry clan of furious, fuming folks since the SCOTUS ruling, to be sure, petulant and paranoid to boot. To most ordinary people, a humble please-and-thank-you request sounds downright polite. That's what came to mind when I first read it.

No following certain posters around and always telling them to provide links - is stalking

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Following a poster all over the board and always telling them to post links is staling and borders on harrassment. There is pretty much no post of hers without someone coming back saying prove it. Provide links, provide links. And then when she does provide links she's told "not credible".

And yet no message from the one singling her out and not asking links from the OP who first talked about group visits.

And your assumptions of name calling regarding the SCOTUS ruling actually I could give a about that. I've got health insurance and that doesn't affect me so I could care less. Nice try at deflecting from the matter being discussed. Just a bunch of spiteful hate words that have no meaning come to mind when I read it. So call me all the nasty names you want. It's meaningless.

BTW - Still don't like stalkers and people harassing certain posters.

OMG, there's is nothing unusual in informed, adult discourse - to provide and expect

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reliable, sound academic source documentation. In fact, not crediting information or even ideas gleaned from any literary or media source is plagiarism and is against the law. To the contrary, if there IS NO SOURCE, which so often is the case with the ones who squeal the loudest, and it turns out they are just running their mouths without the faintest idea of what they are talking about, making it up as they go along, it becomes readily apparent.

Either way, the argument is automatically discredited, and this entire exercise in futility only succeeds in undermining one's own credibility, and becomes nothing more than a colossal waste of time. Willful ignorance inevitably leads one to become ensconced in cyclic bottom feeding behavior ad infinitum, a sad and shabby existence, no doubt. One thing is for sure. It does not win elections.

Then like I posted why didn't she ask the OP. Why did she go - after a certain poster -sm

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Who agreed with the poster who posted the information in the first place.

I just don't happen to agree with bullying certain posters because you don't like what they write.

Google the information and you will find what the OP was talking about.

People need to start doing searches for themselves. I did. Was very easy and fast to find the information. I got tons of links in less than 1 second.

So go ahead with the name calling too. If a poster is being bullied or harassed I will post.

And yet, still no answer to my original question. Go figure.

"go after"? She asked for more information from the - sm

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last person to have posted on that conversational thread. I don't get the confrontational attitude on this board. It is a normal practice on most professional boards to post a source that shows how you reached your opinion. It used to be that way on this board way back when. So what if someone doesn't like your source?

Going back to the original message - sm

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Why did the poster ask Conservative to post a link? Why did she not ask the OP who brought the subject up? Why Conservative? Her conversation was agreeing with the other posters. Why does Conservative have to provide a link to every post she posts. Why ask her to provide a link, but not the one who originally posted?

But she didn't write anything in her message that would require - her to post links

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All I'm saying is if you want a source why not ask the poster who originally posted. Conservative wrote nothing in her post that would require her to post a source.

Why does it matter? It was conversation between - see message

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more than two people on a public forum. A person asked for more info. Why are people here so hostile? I thought this would be a place to share information and ask questions. I guess I was wrong. Sorry. Bye.

No: thinking that posters are being followed and stalked - is paranoia

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simply not true - sm

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Regarding your assertion regarding Conservative's posts: A search of the entire board all the way back to May reveals that your assertion ("there is pretty much no post of hers without someone coming back saying prove it") is patently incorrect.

Not the OP, but here's one from the American Academy - of Famiy Physicians

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The general overview is a quick and informative read that helped point me in the right direction on how to find further reading. IMO, it sounds like a good idea that would help take the pressure off PCPs who are in chronic patient overload and to ease up on the hours sick patients spend in the waiting room

I went to something similar when I was first diagnosed with diabetes, but it was offered within the county health care system where I receive all my medical care, which BTW is excellent. It was an informal diabetes management and nutrition class attended by about 8 or 10 other newly diagnosed diabetics. There were 6 sessions where structured presentations were done, lasting about 45 minutes to an hour. The class was followed by an open-ended Q&A. Sometimes we ended up staying more than 3 hours for that. The format made acquiring the information easier and much more FUN than an in-and-out routine PCP followup.

Discussions were not strictly confined to medical content. We talked about the emotional impact of the diagnosis just as much as the physical aspects, and how it affected relationships with family members. Some of the best help was how to assemble food group portions within meals and snacks over the day (much different than nondiabetic meal planning), meal and medication timing strategies, and help with recipes and grocery list do's and don'ts. Learning how to use a glucometer and take glucose readings was much less intimidating than it would have been had I tried to do it at home alone, all depressed, fearful and tearful. Initial management of diabetes is daunting at best, super time consuming and can be VERY overwhelming. The classroom instruction proved to be invaluable and eliminated a LOT OF STRESS.

In some ways it was similar to Weight Watchers support group format, where the choice to actively participate (or not) strictly up to the patients and, for the record, nobody was FORCED to attend at all. Most defintely, I received more comprehensive information than my PCP could have provided in the limited amount of time allotted for clinic visits. I found those classes to be extremely helpful, especially when going through the life-altering initial shock of this new diagnosis.

Hope this is more helpful to you than the squabbles over where to post and stone silence over how to learn more. Maybe it has something to do with the fact that the more you learn about this, the less credible the "information" in previous posts becomes.

http://www.aafp.org/online/en/home/practicemgt/quality/qitools/pracredesign/january05.html

"Class" is very different than a substitute for - 1-to1 contact with medical care

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"Classes" in all types of illnesses have been around for decades. Replacing medical care with group office visits is a different animal altogether and is not "medical care". Spin it any way you want - NEWS FLASH - IT IS NOT HEALTHCARE. You want your Gyne and Pap smear done in a group?

What part of expanded access and voluntary CHOICE - are you not getting?

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This was a group visit, conducted by a staff specialist team, consisting of a certified nutritionist, a dietician with a PhD, an endocrinologist and a Family Medicine MD. Two sessions were attended by a staff psychologist AND psychiatrist, brought in specifically to address two patients' special needs who were taking psychiatric medications.

How hard are you trying to miss this point? I was referred to the management team by my PCP. They monitored my progress and reported back to her with specific recommendations to her regarding clinical followup with my routine PCP visits. This is what formal medical practice looks like, isn't it? Group visits DO NOT replace conventional clinic visits or physical exams. They provide sound medical education and treatment options delivered in alternative settings tailored to individual needs within a specific patient population.

If your classless and grossly ill-informed gyne pap comment is any indication of how your party's candidate is going to frame this issue, Obama ought to win by a landslide in November, if for no other reason than an irreversible, self-inflicted GOP repulsion factor.

What part of expanded access and voluntary CHOICE - are you not getting? - Wow- ***

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So intent on ***, YOU missed the point of several posters above.

Romney WILL "win by a landslide in November, if for no other reason than an irreversible, self-inflicted" Dems/Libs "repulsion factor"... Not to mention the Dems/Libs inflated egos, self-inflated self assessment of their non-existent intelligence quota.

Try actually reading your original posts. If posters on here think the group visits suck...so what? They are entitled to THEIR opionon and should not to suffer through your *** of anyone disagreeing with you, written in a the same *** of your previous posts.

"Classes" for illnesses remains very,very different than a "group office visit"...***

READY, SET, FLICK YOUR BIC!!

P.S. Here's a complete copy of the post that was being responded to, NONE OF WHICH YOU PORTRAYED ACCURATELY IN A SCATHING RANT. OMG - what length will you go to in attempts to avoid the truth of what was posted? Guess we ALL got that answer.

"The general overview is a quick and informative read that helped point me in the right direction on how to find further reading. IMO, it sounds like a good idea that would help take the pressure off PCPs who are in chronic patient overload and to ease up on the hours sick patients spend in the waiting room

I went to something similar when I was first diagnosed with diabetes, but it was offered within the county health care system where I receive all my medical care, which BTW is excellent. It was an informal diabetes management and nutrition class attended by about 8 or 10 other newly diagnosed diabetics. There were 6 sessions where structured presentations were done, lasting about 45 minutes to an hour. The class was followed by an open-ended Q&A. Sometimes we ended up staying more than 3 hours for that. The format made acquiring the information easier and much more FUN than an in-and-out routine PCP followup.

Discussions were not strictly confined to medical content. We talked about the emotional impact of the diagnosis just as much as the physical aspects, and how it affected relationships with family members. Some of the best help was how to assemble food group portions within meals and snacks over the day (much different than nondiabetic meal planning), meal and medication timing strategies, and help with recipes and grocery list do's and don'ts. Learning how to use a glucometer and take glucose readings was much less intimidating than it would have been had I tried to do it at home alone, all depressed, fearful and tearful. Initial management of diabetes is daunting at best, super time consuming and can be VERY overwhelming. The classroom instruction proved to be invaluable and eliminated a LOT OF STRESS.

In some ways it was similar to Weight Watchers support group format, where the choice to actively participate (or not) strictly up to the patients and, for the record, nobody was FORCED to attend at all. Most defintely, I received more comprehensive information than my PCP could have provided in the limited amount of time allotted for clinic visits. I found those classes to be extremely helpful, especially when going through the life-altering initial shock of this new diagnosis.

Hope this is more helpful to you than the squabbles over where to post and stone silence over how to learn more. Maybe it has something to do with the fact that the more you learn about this, the less credible the "information" in previous posts becomes."

Okay, now that is creepy. Maybe everyone could chime in - and help with the dx - LOL

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The thought of sitting in a group while everyone hears my medical problem is a bit too creepy for me.

It could be a comedy skit if it wasn't so sad that this is what our systems has come to.

Probably the point of the OP before the pile on - by the wild-eyed Libs circling for attack

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When I go to a doctor, any doctor for any concern, I don't want to discuss any of my personal business in front of anyone else. That's the purpose support groups, workshops, and classes. The creep factor is too much. Too bad some can't make a comment on how creepy they find that without the usual Dems/Libs attack dogs going for the jugular because you and a few others "OMG" had a different opinion and valid concerns.

THANK YOU! - SM

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So it is like a class or a support group!?! I was getting the impression that there would be something like a ward with people who had broken arms mixed with people who have measles with people who have cancer. Another misleading post, I guess.

The super paranoia on this Board is absolutely amazing. Quite frankly, I would not even know how to google a concept such as this. But I know how to say please and thank you--something the *** could learn, as well as some courtesy.

I was very courteous - sm

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Unlike the replies directed at us. Very hostile and bullying.

I asked very nicely why a certain poster was singled out and why was the question not posed to the poster who originally wrote it. Certain posters are being bulling with always "asking" for links. Only to be told the links that are provided are not credible.

Either way, a poster was singled out when she wasn't the first one to post the information.

Courtesy goes both ways.

Cyber gang beating up an innocent bystander - My take

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Holy Cow! I guess this Board should just be turned over to the conservatives. Singled out--it was pretty obvious the person asking for a link was "beat up." The posts just go down in a line. probably no singling out at all. I think some people need to see the Board as a group converation, which it is, discussing many faceted group concepts. Some seem to want to control everything. No THANKS. You may as well as just talk to yourself then.

Cyber gang beating up an innocent bystander - My take - ...

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"Holy Cow! I guess this Board should just be turned over to the" iberals. "Singled out--it was pretty obvious the person asking for a link was "beat up." The posts just go down in a line. probably no singling out at all. I think some people need to see the Board as a group converation, which it is, discussing many faceted group concepts. Some seem to want to control everything. No THANKS. You may as well as just talk to yourself then."

I was very courteous - sm - Too bad THEY don't extend what

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they demand from others. Their posts are routinely snarky, rude, condescending, insulting wrapped in their loquacious dribble...and they think that excuses their lack of civility. Nope - We see right through their smoke screen all the way down to the bottom of their barrel.

Thanks. I agree. I guess I just don't understand - what if - sm

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why you can't ask a simple innocent question without getting jumped on. I've got a pretty thick skin. Been told and admitted I'm wrong on issues, but to be called all those nasty names just because all I asked was why the question wasn't posed to the original poster to require links. Why this poster? Just was plain ol curious.

I'm reading post after post of people posting thing and now the board is over run with the give me links and if you don't your a liar attitudes. I would never think to ask someone for a link. If they are telling me something I trust what they say. If I'm not familiar with it I research it. I'll open a Google and I'll type in questions like - Is Obamacare a good plan or Will I be taxed under Obamacare or Did Romney say this or that. I just type in so many different version and I get tons of links. Then I open, read and decide for myself whether or not I believe it. But I certainly don't come on the board calling anyone a liar saying... Links please or no links, no dice or anything like that. It's just very rude to be called a liar, so I do try my best to not call others liars.

I guess I just don't understand why so many had to bully up on me over a simple question. It's truly a sad time we are living in.

YVW. - sm

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In my case, it was within a county clinical outpatient setting, provided as part of ongoing care for chronic disease. Many of these group visit milieus are associated with preventive care, holistic and wellness/health maintenance private clinics. Some of them deal with minor problems or routine care like immunizations, sinus problems, colds, flu, scrapes, bruises, etc. Others, like the model described in the American Academy of Family Practice article, are groups of physicians providing a more structured, specialized approach toward target patient populations, such as diabetics, hypertensives, eating disorders and obesity, and so forth.

It's an interesting departure from conventional care which I think holds real promise, and can be useful within the context of health care reform to help streamline care, make it more efficient, and over time will be beneficial to both patients and MDs. It is well received and highly utilized in Taiwan's relatively new and recently implemented single payor system. The article explains it better than I can and gives you some good key search.

LOL. It took real courage for you to politely ask for genuine help on this viper pit of a forum. Looks like you came out of it relatively unscathed and, if it's of any comfort, your class and style is a rare breath of fresh air and a most welcome change from same ole, same ole.

I think it is a great idea - certainly worth trying

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I have often wondered why so much emphasis is placed on diseases after they have been allowed to "fester". If a diabetic group addressing nutrition, blood testing, etc., could help, why nnot try it. So many very expensive, painful results from uncontrolled diabetes could be prevented. Same thing for optimal pregnancies, etc. OK, so if it doesn't work, hopefully we will have some real scientific data on what works best--you know, the kind of data scientists can use when they have the BMI correlated with treatment, etc.
of course, we really need to work on the premise that the world is round and carbon-based fuels are a problem too. Way to much science educaation needed. Oh well.

Preventative care, wellness and - alternative medicine specialties

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and have fought many uphill battles against MegaPharms and conventional medicine MDs for decades. Good to see they are FINALLY making some headway and will get the opportunity to demonstrate their value, in terms of cost control and advancing improved medical care. It's no wonder partisans bent on science-bashing, terminal denial, status quo or (worse still) more regressive approaches are launching such bitter last-ditchs assaults. Even so, political health care battles have enjoyed much better success in pushing progressive agendas forward than in the environmental arena, where the consequences of failure are extremely dire over the long term.

Any idea how long it took to convince the majority of the global population that the world's not flat?

There was nothing paranoid about what I asked - what if - sm

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I asked very politely a question. Why did you ask a poster, who is agreeing with what another poster said for links and not the poster who originally posted the message.

Maybe you accidentally posted under the wrong poster. Will give the benefit of the doubt, but reading the post you replied to there is nothing in her post that would require her to provide a link/source.

Also, a lot of times in our communities they don't announce everything they are doing in the newspapers. Sometimes we hear things by word of mouth. There is not always going to be a link. Can you see how silly I'd look when the insurance lady told me on the phone she doesn't know if the rates will go up since they laid off 150 city workers if I turned around and said "please provide a link". She'd probably say to me "what are you calling me, a liar?"

I was very courteous in my post. I asked a simple question because I was curious why you posted to her and not the original poster that brought the subject up.

I am sorry. Didn't realize that I'd get so beat up and called paranoid, an angry clan of furious fuming folk, petulant, paranoid, ignorant, bottom feeder, sad and shabby, and told to take drugs.

All that over a simple question of why you didn't ask the original poster to post links to back up what she said.

I guess its sad to know that if you ever ask a question you'll get beat up so bad for asking.

I guess the lesson is we could all be kinder to each other and - sm

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not always assume the worst.

Yeah and these namecallers are the ones - saying they want civility

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That attitude comes out of the Media Matters playbook...All the while the owner is setting fire to Mother Theresa's hair, calling her a liar and demanding a "link", he's telling you he wants "truth" and fairness. Yeah right. Some flame and troll because they can and others because flaming and trolling is in their DNA. They wouldn't spit on Mother Theresa's hair to put out the flames. Fact of the matter is some are just too lazy to do research. Then you got the group that lies in wait for the post/link for the sole purpose of attacking the poster - Guess they think it makes them look intellectually superior (they just look like jacka_ _ es). Too bad for them, everybody posting here recognizes those board bullies for what they are.

Please post a link--never heard of such a thing - thank you - nm - Don't you know how to use your search bar?

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please and thank you

maybe she doesn't - she may lack your internet skills - no harm, no foul

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No, it was not "instituted under Obamacare," - sm

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and it's not practiced because physicians can't afford to see patients individually. There is a VOLUNTARY interactive preventitive care/wellness/holistic care delivery alternative under Taiwan's single payor system where group clinic visits are open 24/7 for 12 hours per day where group clusters are seen for reduced fees, but it is only one in many millieu choices offered. It's all about providing ACCESS and CHOICE, not trying to insist that "one size fits all." Fareed Zakaria was talking about it this past weekend on CNN.

It wouldn't be unreasonable to suggest that some veterans would feel more comfortable in an interactive setting when receiving medical information and discussing medical, psychological and social concerns specific to past military experience or shaed medical disorders. There may indeed be strength in numbers in this scenario, where the outcome may prove to be more productive than one-one-one visits, which to some folks might deem "dehumanizing" by comparison, as *** has suggested. This is NO WAY takes the place of physical exams or impedes access to conventional care. Again, we are talking about voluntary participation that offers alternative choices to patients.

There are numerous group visit models, one of which is DIGMA (Drop-in Group Medical Appointments), a system developed by private practice physician groups. I remember reading about one that was started back in the 1990s, I think in Seattle. They can be searched that way, or by using some other designations such as convenience care clinics, retail clinics, walk-in clinics, etc.

give rationality a chance - another MT

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Doctors can give any reason they care to for why they are lumping patients together to make more money. Doesn't mean the reason they give is the real reason. Also, it isn't a new thing for groups of people to attend sessions by doctors on topics such as diabetes, heart disease, reduction of risk factors for the above or other chronic conditions. What is described above sounds like this kind of thing with question and answer sessions. Certainly, individual sessions are still a necessity for any active issues, diagnostic testing, etc.

As someone else pointed out in response to a different poster, concierge practice has been around for a long time. I have friends in Atlanta who for years have been without insurance and have a relationship with a doctor such as described. They pay a fixed amount monthly to the doctor, and this covers as many office visits as needed or none at all if they aren't sick. Of course, this doesn't help with outside expenses, labs, testing, etc. This is the way this doctor has chosen to see patients and has nothing whatever to do with our current President. There are different kinds of concierge doctors for different reasons.

The Affordable Healthcare Act has nothing to do with either group visits or concierge medicine.

Concierge practice very different than - Group visits, supports groups, discussion groups

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and is like comparing apples and beef. Concierge medicine gives you the opportunity to see a physician, face to face, individually for your care in his/her office, without several other strangers being present and participating in your "office visit". Nothing wrong with concierge. The "group visits" are exactly that and have been pushed in my area, especially for vets, in the last 8 to 10 months, with them only being "allowed" a personal, individual, face-to-face visit once every 9 months ...nothing at all like concierge medicine, which was the original point before the liberal attack mode kicked in.

Definiton of "concierge medicine" - Since clear so many are confusing

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concierge medicine with forced group office visits. HUGE DIFFERENCE and also clear that, before those singing the praises of group office visits and attacking those stating they thought they were "creepy", had no idea what the difference was. Good example of why you should do a little research BEFORE you attack someone for their opinion. But then, we all know there are some on here that LOVE to attack for the sole purpose of attacking.

"Concierge medicine (also known as direct care) is a relationship between a patient and a primary care physician in which the patient pays an annual fee or retainer.
en.wikipedia.org/wiki/Concierge_â��medicine - Cached.Cn"

Our doctor switched to that about 15 years ago - files no insurance - nm

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nm

Universal payer would be a wonderful solution to the insurance problem - - nm

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Only in the *** mind - Not working for UK/Canada, etc

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.

You cannot say the words conservative Republican - but you can use the word comunist?

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If you spell it conservitive republicon, would it be okay?

Sorry - Moderator - sm

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Sorry - trying to clean up the board. I am trying to get rid of the personal attacks, name calling. It makes it hard when there is a long post and in and between discussion about issues someone throws in an insult.

Trying to get it cleaned up so it's fair to all. I'm getting tired of the name calling especially right after I post a message asking posters to stop name calling. But I did think it was amusing to see someone disliked my post asking posters to stop calling other names.

The text in which you are referring to was an insult directed at and in clear writing conservative republicans. I left the message in, but took out the party's name that the insult was directed at. Tired of posters calling the other side uneducated, ignorant, stupid, un-informed and any other insult directed at posters. Politicians are a different thing. I understand posters frustrations directed at politicians. That is why I leave most comments directed at politicians like Romney, Obama, McCain, Palin, etc up.

It's a fine line between freedom of expression and insulting.

Reference was not made to the party and - there was no intent to insult

[ In Reply To ..]
RE: http://general.mtstars.com/302810.html

In this earlier comment about group appointments, Conservative (the poster, not the party) wrote:

"...Whose to say where that information would end up, or who those in the group would decide to share that information with? The whole concept is very DEHUMANIZING."

RE: http://general.mtstars.com/302849.html

In my comment about group appointments, I wrote:

"There may indeed be strength in numbers in this scenario, where the outcome may prove to be more productive than one-one-one visits, which some folks might deem "dehumanizing" by comparison, as *** (Conservative, the poster) has suggested.

By this I was simply contrasting two different points of view. Whereas veterans may feel more comfortable in groups discussing shared military-related medical problems (and less comfortable in one-on-one encounters), others (meaning Conservative the poster) may deem group appontments "dehumanizing." All I meant to do was refer to what she had already said in the above referenced post...that she finds group appointments "dehumanizing."

Implied here is that the flip side may be true for other patients, who are perfectly comfortable with interacting in group appointments, and may deem the one-on-one visits to be "dehumanizing." I say this because in my personal experience, I found the group appointment settings to be very engaging, where multiple discussions are occuring simultaneously. This helped me gather more information quickly, and hearing others discussing similar problems helped me remember questions I wanted to ask and enhanced awareness of multiple issues that had not occured to me the same time.

Personally I find the one-on-one visit much more sterile, where you wait for an hour or two, reading a magazine, bored out of your mind, and fighting off sleep. Vitals are taken and often not shared with you unless you ask. Later you are called into a room, disrobe and slip into that charming gown which used to be cloth, but now is paper, that ties in the back and exposes your backside. While you wait some more, you try to get comfortable, sometimes feel a bit nervous about the exam or the news you may be getting about lab tests, and in the meantime, more often than not, forget the questions you had or the things you wanted to report to the MD.

The PCP finally arrives, has a 15-minute time slot allotted (if you're lucky) that barely allows time to report lab findings, renew medication refills and rechedule a followup appointment. Dehumanizing to some. I suspect some veterans dealing with amputations, disabilities, PTSD, problems with social reintegration and plagued by suicidal tendancies may share that same sense of detached anomie in private clinic visits and may very well do better when in the company of fellow veterans gong through sme of the same things.

In other words, what's good for the goose, may not necessarily be good for the gander. I don't understand what is insulting about that.

inconsistent practice - sm

[ In Reply To ..]
http://general.mtstars.com/302786.html

Post referenced fixed - Moderator - nm

[ In Reply To ..]
nm

going out on a limb here - umm...err...

[ In Reply To ..]
My sole purpose in referencing that post was to bring to your attention your own inconsistent practices with regard to editing posts. After all, if the board is rife with references like "liberal commie" it's reasonable for anyone to wonder why you would edit a poster for saying "conservative republican"!

I responded very reasonably to a recent assertion that I am a commie backer, yet you edited me for saying "how dare you" (citing that posters should not "be writing posts that open themselves up for a barage of insults.") (!) This is a political board. A barage of insults can ensue from any post. It's hard for me (and perhaps others) to understand how "how dare you" is more of an insult magnet than calling someone a commie backer. Here's what I say: let the smack-down remain. And let me respond to it.

You are creating problems with your capricious and inconsistent editing: By giving some posters a free ride while sanctioning others, you are shooting yourself in the foot by creating exactly the kind of environment you say you want to put an end to!

My reply - Moderator

[ In Reply To ..]
I am deleting out insults. I'm trying to get the bickering down. Every time after I post a message for posters to not call others names, i read posts calling other posters ignorant, uneducated, haters and other names. I am editing posts from both sides and I am getting emails that people are not happy I'm editing out their insults (both sides) what you say is inconsistent so is the other side saying it.

I edited out your words of "how dare you" for a reason. I would have preferred you not to use them again. I explained the post was confrontational opening it up to personal arguments, which is not what this board is for. It takes the message of discussing an issue into a personal fight with other posters. I have deleted out the offending words of that post. Posts are supposed to be about issues. If someone calls you a name I will edit it out. If you are truly offended please let me know. Don't make posts personal. That is for everyone.

I am also getting emails on things that people are saying they take offense to like someone writing I don't care if you don't like my post, telling me its offensive. So to make the posters happy I delete the offensive words. I'm trying to be fair to all. I will not silence another persons opinion simply because a poster does not agree with them. If someone calls you a name, that comment will be deleted. If someone calls a politician a name that comment stays in.

I am asking posters once again to stick to issues. Discuss politics. Do not makes posts personal. I will continue to delete attacks or offensive words, but not the content of a message. Don't take on another poster in trying to get into an argument with them.

Just talk about the issues.

"to make the posters happy I delete the offensive words" - I rest my case

[ In Reply To ..]
Sorry, I think this is fruitless.

oh for goodness sake - let's talk

[ In Reply To ..]
Yesterday, in response to an honest question regarding "obamacare", I was treated, along with profane language, to the following: "...just because you back the Communist...." (!)

My response was more than reasonable: "Asking a question about the reach of the IRS is likely of interest to both parties. How dare you react to this by stating that I 'back the communist'".

I would just love to know exactly what is so wrong with "how dare you" that you had to edit it - while the implication that I am a commie sympathizer remains.(!)

Do you really think that saying "how dare you" is somehow over the top, but implying that posters are communists is not?

There is no fine line between freedom of speech and insult. It is a rather stark demarcation. You can't have it both ways. If it's okay with you that posters resort to calling others commie sympathizers, then you really need to back off and allow some of us to say "how dare you".

See message - Moderator

[ In Reply To ..]
I have fixed the message deleting out offensive words.

The only thing I removed from your post was "how dare you". It is confrontational and leaves it wide open for arguments.

There is a thin line between freedom of expression and going one step over.

I'm going down the board to get rid of confrontation and editing out offensive words.

Nobody should be calling anyone commie sympathizers or ignorant, uneducated, etc. At the same time nobody should be writing posts that open themselves up for a barage of insults.

I'm trying to get that to stop.

good question - nm

[ In Reply To ..]

You cannot say commie but it's okay to use - right-leaning wingnuts?

[ In Reply To ..]
For those politicallyu/historically challenged, "Communist" is another party exactly like Democrats, Socialits, Marxists, Fabian Socialists and Republicans.

What solution would it provide for the physician? - Just curious because

[ In Reply To ..]
I have worked inside physicians' offices for years, some in billing and practice management, and am unsure what would be the benefit to the physician that has decided to stop taking any insurance to go to a universal payer. I can understand thinking it would be a benefit to some patients but have a real hard time understanding the benefit to the physicians, unless they are going to pay way above Medicare.

Most importantly a benefit to patients - sm

[ In Reply To ..]
It is pretty complicated, but I will try in general terms. I worked in a large specialty geriatric service clinic. Most patient's received services under Medicare, Medicaid, Veterans, private insurance, or county funds for necessary uncovered services. At times, Medicare would say that a patient's care would only be paid for in an acute care setting (in-hopital), another patient would run out of therapy benefits after a stroke and would need assistance from the county. Each insurance company had their own set of rules and benefits. We employed a billing coordinator, a Medicare specialist biller, another specializing in MA and a couple of general billers. Often services would have already have been provided by medical staff that the payors would then deny payment, because it did not meet their benefit criteria. The manuals of regulations and updates would make your head spin. The medical staff frequently would curse out the insurance companies. I recall one patient in particular who could have been treated as an outpatient, wished to be treated as an outpatient, but had to be admitted to the hospital in order to have treatment covered, which was much more expensive and undesirable. The physicians, nursing staff and therapists could have spent all of their time being concerned about the patient care, instead of how to work the system on behalf of the patients. Yes, the billing staff would probably be cut in half, also lowering the cost of care. Also, hopefully the private insurance companies would not be raking in the dough and profits out of their extortion, thus more money going for actual care.

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