So I've been shadowing an internal medicine physician specializing in geriatrics (old people) who works in a concierge setting. The concierge part seems highfalutin, kind of opposite of the internal medicine part. But that's just on the surface. After shadowing her just once, I can see that it actually allows her to give back more to the community, see more indigent patients, but then again, maybe that's just her outlook and maybe she would've done it even if she wasn't in a concierge setting.
Anyway, for those that don't know, because I certainly didn't know before shadowing her, a concierge practice is one in which you pay a flat rate/year to see the doctor. The price seems pretty hefty, $1000-$3000 or more, but a patient of a concierge doctor gets to see him/her whenever she wants, call/email the doctor (and actually get responses), and even have the doctor be there when the patient has to make an emergency visit somewhere or just tour nursing/assisted living homes. Considering all of that, the $1k-$3k is a pretty good deal. For those who require that kind of care.
Here are some things I've noticed from shadowing this doctor, some related to the concierge nature of her practice, and some not:
- Time: One big perk of having a concierge type of practice is simply having more time—time with the patients and time to be a human being for the doctor. I can definitely see this comparing Dr. S's consults (Dr. S=concierge/internal med/geriatrics doctor I'm shadowing) and the visit I had with an ob/gyn recently. Dr. S has a whole hour blocked out for a patient, giving them time to chat about things unrelated to the patient's health (Blackberry vs. iPhone, politics), and most importantly giving the patient time to think if he/she has any other questions, of which there usually are. I know that all of this is the essence of primary care, regardless of what type of practice it is, but I feel like being in a concierge type of setting allows you to develop that essence more—the essence of building relationships with your patients and addressing all the patient's problems, mental, physical and otherwise, in a holistic way.
- Time is funny. It helps define who you are. Because time is limited, everybody has to prioritize. Specialists prioritize their time to focus on being skilled in one narrow subject; internal medicine physicians prioritize their time to take a step back and look at the whole picture, make sure the patient's medications aren't negating each other or having an undesired reaction with another. Specialists vs. primary care…and not just in terms of career choice, but from the health systems point of view.
- Coming back a little to having time to build relationships with one's patients, I feel like that's what Dr. S is really in this business for…and so she prioritizes that and opened up a concierge practice. See how that works?
- Patients: more than meets the eye: Many patients are smart; not all, but many; and not in the same way that you are as a doctor. So that's one reason to respect them, but many if not all of them have gone through a lot of hardships. Ones that you can't even begin to imagine. So respect them, because they deserve it.
So that's all I have for now. I now want to open up a concierge type of practice some day. It's funny how the people you meet really influence what you do later in life and what you want…makes me (almost) believe in fate.
