After scanning the internet ads, I scheduled an appointment - a “Meet and Greet”- with a local physician. She was accepting new patients and belonged to an affiliated network, often referred to as a “concierge program”. I could subscribe for an annual fee paid to the program that manages the network of primary care doctors. Two main advantages offered are: no time limit on my appointments and instant availability of a substitute doctor if mine is out of town or I am out of town and need a physician. That substitute doctor would be part of the network and have access to my health records.
By enrolling in the “concierge program”, I would have an ongoing relationship with a doctor who limited the number of patients in her practice enabling her to really deliver to to her subscribers her considerable attention and skills. The “Meet and Greet” was free of charge. We spent an hour together.
Here is the letter I wrote to the impressive local physician i interviewed (without charge) in the scheduled “meet and greet” interview to determine if my needs would fit what she was equipped to deliver as my personal physician. Perhaps my experience will be useful for others, like me, who are looking for a fit when searching for a new doctor.
Dear Dr. “Smith”,
Thank you for meeting with me last Tuesday to see if we could work together to manage my ongoing wellness and medical needs. I appreciated your enthusiasm for your work and saw echoes, in your intentions, of where I began at The Hospital of the University of Pennsylvania in cofounding the first Women’s Wellness Program in the Philadelphia area in 1985.
Much as your concierge network posits now, back then I believed that screening for lots of different health issues would help women lead healthier lives, and catch problems early to prevent their further development. However, experience and scientific data have altered my view for what will work best for women like me who are proactive in choosing health habits to enable enjoyment of their own best lives. On the scientific evidence front: Early detection of invasive breast cancer has not saved lives but it has generated a massive revenue for the health establishment at a huge cost to the global economy.
Specifically breast screening and the over diagnosis and over treatment that results was calculated at $4.2 Billion in insurance reimbursements in the first year after diagnosis, in the USA in 2012. By now that figure has probably doubled. And a worldwide scholarly effort is now in its 12 year, to evaluate the “disease” of widespread over diagnosis and over treatment of many different diseases, by a world respected consortium sponsored by The World Health Organization, The British Medical Journal and others which you can see it at preventingoverdiagnosis.net
If you had been available to be my personal physician without my signing up for annual screening evaluations, I would have loved to work with you as my own best doctor. However, I do not want to be offered a list of screenings; nor to visit when I feel well, to discuss how I feel. What I am looking for is a primary care physician that I can call on when I feel the need.
On studying the business model of your concierge network of physicians, I see how the economics of lots of annual screening tests reimbursed both by insurance and the patient can generate sufficient revenue for the doctor’s office to compensate for a smaller patient base. And I see how the enrollment situation with [A Medical Network] can generate the funds to them to very profitably support the array of persons shown on their website. Their highly profitable business model does make sense for them. However, with my already well developed good health habits of daily exercise, healthy eating and a rich spiritual life, this model does not work for me.
I thank you for our informative interview; I like you very much and wish you well in your practice.
Winnifred Cutler, PhD