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Flat-fee payment option increasingly popular with doctors & patients

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Monday, July 9, 2012 - 7:00am

If you're one of the millions of Americans who have received a letter from your doctor informing you they're changing things up to become a "members only" practice, you know the growth of so-called "concierge medicine."

A government commission recently found the number of such red carpet practices has increased five fold in the last six years.

Dr. Jennifer Chilek went into private practice eight years ago at Stone Creek Family Medicine in Montgomery, Texas, but, like so many doctors across the country, she's felt the pinch as overhead goes up and reimbursements go down.

"The insurance companies have handcuffed small practices," she says.

The only way to make ends meet was to bring in more patients, which in turn means less face time with your doctor.

"The health care system is destroying the doctor-patient relationship. I couldn't have kept going the way that it was," Chilek explains.

So this year Chilek joined an estimated 3,500 private practitioners who've switched to so-called concierge or boutique medicine, which has swept the nation the last decade.

Patients pay an annual fee from $600 to $5,000, even $20,000, and insurance is not accepted.

Chilek chose a newer, more affordable model called practice membership that works with your insurance.

Sample practice membership fees are as follows:

Individual: $1,200 per year; $100 per month
Couples: $1,800 per year; $150 per month
Families: $2,400 per year; $200 per month

Benefits include same day or next day appointments, more attention from your doctor, more communication by phone, text or email and custom wellness programs.

When the letters went out informing patients many were understandabley shocked at first.

"Some patients were angry and frustrated and thought they were losing their doctor. Others said, 'Hey, I'm on board. Sign me up now,'" Chilek recalled.

Some doctors who've switched to the membership model said they've been surprised by the patients who are jumping onboard.

It's not the "one percent," but more often your average "nine to five-r" who just doesn't have the time to sit in a waiting room.

"I was 100 percent for it," says Donald VanOrden

VanOrden owns a small company that buys and sells 18 wheelers.

He says he can't afford to waste time.

"It's absolutely the worst thing and it's extremely frustrating. I have had to wait three hours to see a skin doctor and, at one point, I was about ready to get up and walk out," he explains.

VanOrden and his family were among the first to sign up.

He said, "You can't put a dollar amount to not have to wait in a doctor's office."

"There are terms like 'boutique' and 'concierge' that make you think it's this wealthy elite class that can afford this when truly it's not," Chilek says.

Of Chilek's 3,000 patients, nearly 400 have signed on.

Fees are guaranteed for the next three years, which Chilek said helps as the current health care system continues to evolve.

"If Medicare's 30 percent cut goes through next year like it's supposed to, I'll still take Medicare. I'll take what they give me, but...this other part of the practice is what's going to keep my doors open and keep the doctor-patient relationship," she explains.

According to the American Academy of Private Physicians, the number of concierge doctors is expected to double every 12 to 18 months for the next three years.

The American Medical Association acknowledges concierge care may be a necessary component of health care, but adds if such practices become too widespread, they could "threaten access to care."

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