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50 Questions You Should Ask Every Concierge Doctor.

By Michael Tetreault

Editor of Concierge Medicine Today

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Published By Docpreneur Press And Concierge Medicine Today, LLC. © 2016 All Rights Reserved

This Content May Not Be Copied, Distributed Or Reprinted Without The Express Written Consent From The Authors.

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“Not often does one have the opportunity to have this kind of doctor that you feel is part

of your life.”

~Priscilla D. | Ohio

“I’m looking for a doctor that is old-fashioned. Paper Chart

Security.”

~W.Y., | Ooltewah, Tennessee

“I’m looking for personalized care as I'm getting

a bit older.”

~Brien | Livermore, CA

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“I prefer a personal relationship with a Doctor

that knows everything about me.”

~E.N. | Perrysburg, OH

“I’m disillusioned with government control of

healthcare.”

~T.B., | Minneapolis, MN.

“I need a higher level of service and faster response times.”

~Richard | Miami, FL

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More People Are Choosing To Use and Find A Concierge Doctor Across The U.S.

(Quotes from real people)

"I'm a self-pay patient. Apparently, the modern

health care business model no longer knows what

to do with people like me. I'm a PERSON, not a

set of billing codes. I shouldn't have to deal with 4

separate bills from one trip to the Doctor. I

shouldn't have to jump through hoops to find out

what my lab work is going to cost just so that I can

pay for it on the same day I get the work done. My

medical care should be between ME and my

DOCTOR. I see no reason why there need to be a

half dozen corporate bureaucrats involved. I

could keep typing, but I think you get the drift."

--Eric in Ohio

“I need Doctor that actually reads my chart.”

--Myrtle Beach, SC, March 2016

“It provides better care for my chronic illnesses.”

--Greg in Jeffersonville, IN

“I do not like my network options.”

--Kim in Aventura, FL

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“We are moving to NJ. We are very pleased with

our current Concierge Doctor, and would like to

continue with a Concierge Doctor in our new

location.”

--Sheila, New Jersey

“Concierge Medicine just provides better service

and there is no waiting for an appointment.”

--Harper, Ohio

“Disgusted with five minute medicine!”

--V.R. in Oxnard, CA

"We are a family of mom, dad, and 10 year old

daughter. Dad's retirement from his job means

leaving his insurance plan. We are healthy and

looking for affordable Direct-Pay Medical Care or

Concierge Care. Thank you very much."

--Nancy in Georgia

“I cannot get the attention of my various

physicians.”

--W.G. in Naples, FL

“I’m not satisfied with current care quality.”

--M.M. in Harvest, AL

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Part 1 of 3

Introduction to Concierge Medicine

Concierge Medicine is a relationship between a patient and a primary care physician (in some cases, a specialty physician as well) in which the patient pays an annual or quarterly fee/retainer. This may or may not be in addition to other charges. In exchange for the retainer, doctors provide enhanced care.

The next time you are looking for a doctor, are you going to look in a directory or online review sites? Most patients use the Internet to briefly review their physician ratings.

We spend more time researching the next car we are going to buy than our doctor … who has

the unique ability to help us live.

Look for a color photo, a well-written profile and some personal details about the doctor. Hopefully, you will find some positive and refreshing patient testimonials and have an attitude of anticipation and excitement before your first encounter.

Concierge physicians care for fewer patients than in a conventional practice, ranging from 100 patients per doctor to 1,000, instead of the 3,000 to 4,000 that the average physician now sees every year.

Over 70% of Concierge Physicians Polled in 2016 Reported That They Treated Between 2,000 and 4,000 Patients Prior to Opening a Concierge Medicine Membership Option In Their Practice. Today, Most Concierge Doctors See Between 6-10 Patients Per Day, Far Fewer Than In Their Previous Business Model. ~Concierge Medicine Today, April 2016

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All Physicians generally claim to be accessible via telephone or email at any time of day or night or offer some other service above and beyond the customary care.

Source: © 2016 Concierge Medicine Today, LLC.

While all Concierge Medicine practices share similarities, they vary widely in their structure, payment requirements, and form of operation. The annual fees vary widely, from US$10 per month to US$1,500 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. In particular, they

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differ in the level of service provided and the fee charged.

Concierge Medicine Today, the industry trade publication and news organization covering the space, reports a steady growth of members-only practices in well-populated metropolitan areas such as New York over the last several years (about 4% to 5% annual growth), including many with specialties in cardiology, gerontology, pain management and other areas in addition to internal medicine.

Concierge Medicine Today estimates a count of around 6,500 verified practices across the U.S. in 2016 and perhaps as many “under the radar” offerings. Since Concierge Medicine for now remains a branded business model and not a certified designation or one recognized by the American Medical Association, it is difficult to quantify the precise number of Concierge Medicine doctors nationally.

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.

It Is More Affordable Than You Might Think.

Despite the high-powered executives using concierge medicine, executives of all ages and backgrounds are not the most popular demographic searching for these types of medical doctors across America today. According to a two year survey of actual Concierge Medicine Patients from across America by The Concierge Medicine Research Collective, the research and data collection arm of Concierge Medicine Today, it reveals that top-level executives account for less than 4% of the concierge

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medicine patients across America searching for this type of healthcare.

Source: © 2016 Concierge Medicine Today, LLC.

With the number of consultants out there saying that these doctors should gear their marketing efforts towards executives and that a significant number of practices are comprised of this clientele, any physician should come to the obvious conclusion that this audience is not necessarily their primary market.

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So, if it's not executives who are searching for this type of care, who is looking for this type of healthcare delivery model and service?

49% of all concierge medicine physician searches by people received online are for Individual plans;

23% of all concierge medicine physician searches received are for a Couple, with no children;

21% of all concierge medicine physician searches received are for Families, with children;

4% of all concierge medicine physician searches received are for Business Owners/Top Executives;

3% - Allowable Margin of Error +/- 3%.

As many people are aware, this type of boutique medicine or direct relationship medical practice delivery model concept is still relatively new. The greatest amount of data compiled to date on the loyalty or renewal rates of concierge medicine patients year after year tells us that these practices have an annual renewal rate of about 94.7%. Additionally, these types of practices are mainly considered Hybrid business models, which means these doctors and their offices accept insurance and charge an annual retainer fee to their patients for enhanced access. This number is based on data from approximately 100,000 patients nationally. These retention figures have proven consistent since the year 2000.

Long term data on these particular kinds of patients is currently being compiled but data supporting the cost effectiveness and affordability of these healthcare models

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is intriguing. According to various physician journals, a patient will remain a patient of a traditional primary care doctor in a typical family practice or general medicine practice, barring an altering event (like a geographic move, death, loss of job, or other unforeseen circumstance) for 5-7 years.

Based upon the data listed above, it appears that retainer medicine or boutique physicians that have a long, relational-history with their patients are reporting higher retention levels that exceed traditional primary care and family practice expectations. This data combined with the fact that this model of medicine provides for closer communication and relationship with people -- we expect that the majority of patients will continue to remain with a retainer-based practitioner even longer than seven (7) years.

The information provided here gives more evidence that these types of medical practices are not just for the deep-pocketed executive. In fact, we have recently learned that over 50% of these types of healthcare consumers make a combined household income of less than $100,000 per year.

All of this data should be very encouraging to the public, as well as the practicing physician anywhere in America. This concept, initially thought of by many as healthcare for the rich -- is now accessible and very affordable for couples, seniors on Medicare, young families and individuals.

Recent research has found that it can be difficult to find a concierge doctor or a direct primary care physician rural areas such as: Idaho; North Dakota; South Dakota; Louisiana and Mississippi. In many cases, there are less than half-a-dozen practitioners to serve an entire state.

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Most doctors’ offices are located in metropolitan areas such as Miami, FL, Phoenix, AZ and Los Angeles, CA to name a few. However, it's a little known fact that over 63 percent of people who use direct primary care doctors and join concierge medicine clinics earn $40,000 to $200,000 per year. Those are individuals, one couple households and families with children. This unequivocally shows that this form of healthcare is affordable to the masses and available to people in major metropolitan centers and surrounding suburbs. It says to local communities, 'we're coming to your town so please come check us out. We'll be open for business in a location near you very soon.'

Since the mid-1990′s, states like California and Florida have seen the greatest amount of physicians actively opening and using these new business models. For most of the country, direct primary care and concierge medicine practices are growing and that growth is rapidly expanding in major metropolitan suburbs as well.

Large networks of doctors who have modeled their medical practice after these business strategies have claimed a significant portion of the market share and thus help to keep prices from inflating too high in major metropolitan markets.

Overall, concierge medicine is thriving in metropolitan markets with the majority of incomes remaining the same or increasing slightly.

The top 4 most popular specialties in concierge medicine are: primary care; family medicine; cardiology and pediatrics.

The typical age of concierge doctor is between 40-59 years of age.

Most concierge doctors treat six to eight patients per day.

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Female concierge doctors fill up their concierge practices 30% faster than men.

Do you want your healthcare needs overseen by a physician who loves what he/she does every day or the latter? Because Doctors play such an important

role in our lives, look for a physician who enjoys his/her work and uses their strengths in life to help

you live a better life!

Career satisfaction in the field among physicians also remains high. Less than 8% of physicians stated they would not make the same decision again. This number overall is very low and career satisfaction with the business model of Concierge Medicine is exceptionally high when compared to traditional, insurance-based or managed care medical specialties.

Educational Resources Available to Learn More about Concierge Medicine

If you'd like to find a medical home or a Concierge Doctor in your area or simply learn more about them, you will want to visit hwww.ConciergeMedicineToday.com or www.DirectPrimaryCare.com.

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Part 2 of 3

Four Starter Questions to Ask -- Avoid These Mistakes When Selecting Your Next Primary Care or Family Doctor

1) Is Eight Minutes Enough Time For Your Doctor To Collect 25 Years of Family History?

Most doctors are busy and they have huge waiting rooms full of people that they need to treat. If you visit your doctor for an average of 8 minutes per visit and schedule a visit 6 times per year, you've spent less than 60 minutes with your doctor throughout an entire year!

Is that really enough time for your doctor to get to know you and make a good assessment of your health risks based on your current condition and family history?

2) Does your doctor have to look at your chart to remember your name?

'Nuff said. I think you get the point here.

3) How full is the waiting room?

Just because the waiting room and parking lot is full, doesn't mean you've found the best doctor. In today's day and age of insurance, doctors join hundreds of insurance plans in order to get their practice listed in more directories. The more directories that the doctor is listed in, the more likely that his/her practice is going to be full of patients that know nothing about him. As you are probably aware, these directories tell you nothing about the doctor, his medical background, patient testimonials, wait-time, etc.

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4) Does your doctor's office have two waiting rooms?

The answer you are looking for here us either two (2) or none. Just a few days ago, I visited my dermatologist’s office. He separated his practice as soon as I walked in by asking patient to go right or left. Right was for 'cash only' patients and the left was for 'Insurance Patients'.

Do you want to know the difference between the 'Cash Only' waiting room and the 'Insurance' side? Let me tell you, there was a big difference. As a cash paying patient, the waiting room was turned into a lobby; there were refreshments, fresh coffee, cold juice, a flat screen TV playing the latest news and more. People were happy.

On the insurance side, there were frowns, ugly furniture, old paint and nine people waiting.

What to Expect. Overall Benefits Also Include:

Uncompromising focus on personalized, high-quality primary care;

Convenient in clinic, phone and electronic access; and

Qualified doctors, nurses, and medical teams providing comprehensive primary care services.

When you visit a Concierge Doctor’s Office, you may first notice that the landscape, paint and initial interior design aspects are different from a traditional doctor’s office.

For far too long, visiting the doctor’s office has been like going to the DMV. It’s time we did

something to change all of that!

“Primary healthcare clinics are moving away from a professional, business-like image towards a hotel or home

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imagery, with the use of domestic-scale plants, lamps, artwork, furnishings and window treatments,” says Mitra Pakdaman, CEO or LA Healthcare Design based in California. “This design strategy is said to reflect psychological support, comfort, personalization, and close interaction provided in the care facilities. Smaller waiting rooms, with more flexible, comfortable furnishings, similar to a home environment; coupled with aquariums as calming distractions, and toys and spaces for children to play are the major changes adopted in the interior design of primary care or concierge clinics.”

Other Services You May Expect To See:

Unlimited Access to your doctor or doctor’s office.

Many offices can provide same or next-day care for urgent medical issues such as sprains, respiratory illnesses, cuts requiring stitches, urinary tract infections, fractures, and more. If you are not sure whether your condition is something your particular doctor/office can take care of, we recommend you call and they will help direct you to the best place to get it addressed.

Unhurried Appointments with doctors who focus completely on your health and well-being.

Your visits may include extended consultations and personalized coaching to create positive lifestyle changes such as weight loss, smoking cessation, and stress management.

LAB TESTS – Many doctors/offices offer some basic onsite laboratory testing at no additional charge (such as pregnancy testing, strep throat testing, HIV screening, and others). For other tests, your DPC doctor/office may send samples to their partner laboratories for processing or refer you to a local laboratory for testing, many times at a significantly reduced/discounted rate. If you would like to use your insurance to pay for

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your tests, many doctors will forward your information to the laboratory to be billed directly to your plan. Check with your doctor/office and ask if they provide this service. IMPORTANT: If you would like to take advantage of discounted cash pricing, many doctors/office often pre-negotiate discounts of up to 75% off of regular pricing for specific tests. Ask your physician/office about this. All testing and any associated costs should be discussed with you prior to ordering and processing any tests.

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Receive health care support in person, by phone, or by email.

In the case of serious illness requiring emergency or hospital care, your doctor can typically communicate with the hospital, send over any relevant records, and coordinate your care during and after discharge. If you have a serious emergency requiring immediate medical attention, call 911 and then either call your doctors/office or have the hospital personnel call them to let them know so they can participate in your care while staying at the hospital. Most doctors/offices can coordinate hospital and emergency care remotely, working with other doctors and care providers over the phone and touching base with you and/or your family members.

Some Concierge Doctors maintain hospital privileges and provide direct, bedside care and coordination at the local hospitals in and around

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their local practice. Check with your physician as to which hospital he/she may admit you to in the future.

Should you need to see a specialist, your provider may coordinate your referral, communicate with your specialist, and work with you to make decisions about and follow through with your care plan.

Source: © 2016 Concierge Medicine Today, LLC.

No co-payments, co-insurance, or deductibles (Note: There are many practice/delivery models used by physicians at these offices. Please check with your physician/doctor’s office and ask them about this.)

Help in monitoring and managing chronic

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conditions such as high blood pressure, diabetes, high cholesterol, asthma, arthritis, etc.

No long-term contracts when joining No restrictions based on age or pre-existing

conditions—everyone is welcome

Source: © 2016 Concierge Medicine Today, LLC.

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"I find the service from practices working with

insurance is too fast paced and lacking focus."

--Kate in Maryland

"Our family finally found a better way to manage healthcare and costs."

--Hanna in Minnesota

"I want price transparency and more time with

my doctor."

--Alan in California

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"Looking for better solution than typical big

hospital practice."

--Patrick in Texas

“Not only do I ‘like’ this but I’m grateful that we started

our concierge care two years ago. It’s yet another degree of

peace-of-mind ...’

Susan G. | Connecticut

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Part 3 of 3 50 Questions to Ask A Concierge Doctor BEFORE You Sign-Up

When choosing a Concierge Doctor, there is an entirely set of new questions that you want to be sure you have answered for you and/or your family.

DISCLAIMER: Concierge Medicine Is NOT Health Insurance. Concierge Doctors work directly with their patients to provide primary and preventive care services that are usually described to patients in our a short summary Agreement/Contract or Patient Services Guide. Concierge Doctors offices do not provide health insurance, specialist care, hospital or emergency care, but can refer patients to providers within a desired network.

It is important to understand that almost all Concierge doctors/offices advise patients to have some form of insurance in the event of catastrophic event or illness. Anyone can become a patient at any time. Typically, Concierge doctors/offices do not pre-screen or deny patients because of their age, race, religion, and national origin, health condition including the presence of any sensory, mental, or physical disability, sexual orientation, education, economic status, employment status or citizenship.

Here’s the upshot: When you combine high-deductible health plan policies with a concierge medical program, you empower people and families to make better decisions about their health care, they in turn receive more comprehensive medical care and then the savings happen and stronger relationships occur between the physician and their patients. One concierge physician said it best when she said that her patients can say ‘I no longer have a doctor who needs to look at my chart to know my name.’

Before you sign-up and pay a Concierge or Membership Medicine doctor’s office their fee, you should schedule a complimentary meeting with that doctor to discuss the benefits, services and cost of their Membership Medicine practice.

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Bring a copy of these 43 questions as your guide. You probably won’t get through all of them (maybe 20-25) … but you should come prepared to get your concerns and questions answered to your satisfaction.

If your questions are not answered to your satisfaction, don’t feel any pressure from the physician or the staff to join at that moment. Move with certainty and spend your money with wisdom.

Most Concierge Medicine Doctors offices do not deploy hard-sell tactics anyway … but there are always a few that do. Most physicians in this sector say they encourage their new patients to take the necessary time they need to decide whether or not this is an expense and professional healthcare relationship they need/want in their lives. Your next physician should be just as respectful.

When Patients Of Concierge Medical Care Were Asked To Weigh-In On Why They Choose Concierge Medical Care, They Said… Source: Concierge Medicine Today and The Concierge Medicine Research Collective © 2012

34% said price was the main reason they chose concierge medical care

29% said insurance compatibility was the main reason they chose concierge medical care

17% said Medicare acceptance/participation was the main reason they chose concierge medical care

6% said more time with my doctor was the main reason they chose concierge medical care

6% said less office staff to deal with was the main reason they chose concierge medical care

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2% said limited/no waiting was the main reason they chose concierge medical care

6% indicated a variety of other reasons not included in the list above

The takeaway here is that a lot of concierge practices focus on limited or no waiting at their

office and not on the real issues driving patients to these clinics, that being: insurance compatibility and price. While more time with

the doctor and same day appointments are nice features of the practice, these were the least important aspects as to why patients choose

Concierge Medical Care.

If you need help locating a Concierge Medicine Clinic near your home/office, visit www.ConciergeMedicineToday.com.

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50 Question CHECKLIST Source: © 2016 Concierge Medicine Today, LLC.

1. Doctor’s Full Name? 2. Total Years In Practice? 3. Years In Practice? 4. Do You Have Multiple

Locations? If So, Where? 5. Do You Have A Web Site? 6. Can I Read Patient Reviews

About The Doctor And His/Her Practice?

7. Does Your Web Site Have The Doctor’s Bio./Background Description On It?

8. What Is Your Monthly, Quarterly Or Annual Membership Fee(S)?

9. How Do I Pay The Doctor? 10. Do You Accept Quarterly

Or Monthly Fees? 11. What Services Are

Covered By The Annual Fee? 12. Do You Offer Any

Discounts For Couples And/Or Families That Join (If Applicable)?

13. What Additional Fees Are Not Included In The Annual Membership Fee?

14. Will I Be Required To Pay Even If I Do Not Need To Use Your Services?

15. What Services Can I Expect To Receive Directly From Your Nursing Staff Or Other Healthcare Professionals At The Practice Each Year During My Membership?

16. Do You Accept Insurance? How Compatible Is Your Medical Practice And Services

With My Health Insurance Plan?

17. Do You Participate In Medicare? (If Applicable)

18. Do I Need Insurance To Enroll Or Sign-Up?

19. Is There Co-Pay? 20. May I See A Copy Of Your

Medical Service(S) Agreement?

21. What If I Need To Go To The Hospital Or Emergency Room?

22. Will My Insurance Reimburse My Monthly Fee?

23. If Applicable, Tell Me About What’s Included In Your Annual Physical?

24. Tell Me About Afterhours Care And The Doctors 24/7 Availability.

25. Can I Still See My Gynecologist? (If Applicable)

26. If A Duplicate Test Is Ordered By Your Office And By A Specialist I’ve Recently Seen, Will You Coordinate With That Specialist’s Office To Receive The Results So I Do Not Have To Go Thru The Same Process More Than Once? If Not, Why Not?

27. What Is Your Annual Patient Retention? (I.E. Do You Retain Most Of Your Patients Annually?)

28. What About Lab, X-Ray And Specialists’ Fees And Hospitalizations?

29. How Long Do In-Office

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Visits Typically Last? 30. How Long Will I Have To

Wait If I Come In For A Visit? 31. Do You Provide Home

Visits Or Delivery Of Prescriptions To My Office Of Home?

32. What If I Have An Emergency Or Need Hospitalization?

33. What Hospitals Does This Doctor Have Admitting Privileges To In This Area?

34. What About The Cost Of Prescription Medicines?

35. Can I Receive Text Messages From My Doctor? E-Visits, Skype Video Chat, Or Facetime Thru Iphone?

36. What Type Of New Technology Do You Use Regularly In Your Concierge Medical Practice?

37. If I Call My Concierge Doctor At 8pm Or 2am For An Urgent Healthcare Concern, What Will Happen? I.E. Will The Doctor Be Available?

38. What If I Need To See A Medical Specialist Or Need Surgery?

39. How Difficult Is It To Get

An Appointment? 40. Do You Provide Same Or

Next-Day Visits With Unhurried Appointments That Start On Time With The Doctor?

41. What Happens If My Doctor Goes On Vacation?

42. What Happens If I Am Hospitalized In Another State Or Country?

43. How Will You, Your Office Staff, Etc., Communicate With Me And Oversee My Care?

44. What Happens If I Move Out Of The Area After I Enroll?

45. Can I Enroll In A Concierge Medicine Plan Anytime In The Future?

46. What If I Get Married Or Have/Adopt A Child?

47. Can I Extend Coverage To My New Family Members?

48. Do You Provide Help For Out-Of-Town Family Members Visiting For A Few Days In The Event That They Have A Health Issue?

49. Do You Have Any Specials/Discounts Running Right Now?

50. How Do I Sign Up?

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Contributors INDUSTRY NEWS AND INFORMATION Concierge Medicine Today

Concierge Medicine Today (CMT), is the premier news and multi-media organization and the industry’s oldest national trade publication for the direct primary care and concierge medicine marketplace. Their web site is the online destination for business, consumers and physicians to learn about the history of this industry, various business aspects of the marketplace, trends, breaking news and more that drive the conversation and generate the national buzz that concierge medicine and direct primary care is creating on a national and international level. For more information, visit: http://www.ConciergeMedicineToday.com.

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50 Questions You Should Ask Every Concierge Doctor.

By Michael Tetreault

Editor of Concierge Medicine Today

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Published By Docpreneur Press And Concierge Medicine Today, LLC. © 2016 All Rights Reserved

This Content May Not Be Copied, Distributed Or Reprinted Without The Express Written Consent From The Authors.