For doctors who are seeking personalized medicine and physician satisfaction, direct pay practices like concierge medicine are proven to restore value-based medicine, prioritize doctor-patient relationships, and shift the focus back to what matters most: patients and their well-being.
According to Medscape’s 2020 National Physician Burnout & Suicide Report, 42% of physicians who participated in the study reported feelings of burnout. The report also detailed the following specialties with the highest physician burnout rates: Urology, Neurology, Nephrology, Diabetes & Endocrinology, and Community Family Practice.
That being said, more and more doctors are discovering that concierge medicine models are great physician burnout solutions.
In American health care, it has been an open secret for the last few decades how problematic the traditional, insurance-based model has become. Insurance costs continue to rise, and yet patient advocacies have taken the back seat. Primary care physicians are bogged down with billing codes and administrative tasks, leaving them with 15-20 minutes, at best, to see their patients.
Unfortunately, all of this has taken a negative toll on the healthcare industry as a whole. The traditional, insurance-based health care model is notorious for poor health outcomes, outrageous health expenses, and a dying doctor-patient relationship.
In terms of concierge medicine and physician burnout, direct pay practices are revolutionizing how the healthcare industry operates. Fed up with the shortcomings of the traditional, insurance-based healthcare model, physicians are finally taking the lead and reinstating the patient advocacy that is the core of their calling.
The success of direct primary care (DPC) and concierge medicine models are rooted on three major fundamentals: First, they have taken the middle men out of the equation. This means no more insurance claims, no more overbearing administrative tasks. The result? Improved affordability and access to quality health care.
Second, time - what is elusive and limited in traditional practices is an abundant resource in direct primary care and physician wellness. Early disease diagnosis and chronic condition management can only be carried out if there is enough time to get to know and keep in touch with the patient.
Lastly, what is interesting about concierge medicine and physician burnout is that the former gives physicians the financial and professional freedom to establish lasting relationships with their patients. This has immensely brought back the joy of extending patient care to many physicians’ careers.
A quote by Clayton Christensen perfectly encapsulates why physicians are burnt out, fed up, and sick of insurance-based practice. He goes, “There are more than 9,000 billing codes for individual procedures and units of care. But there is not a single billing code for patient adherence or improvement, or for helping patients stay well.”
The failure of traditional health care is due, in part, to the fact that doctors are under the mercy of third parties, like health insurance. The traditional model requires billing codes and insurance claims to move forward with just about anything - specialist referrals, physician compensation, you name it.
As a result, clinic appointments with patients are rushed, overloaded, and ingenuine because: 1) sessions are premeditated according to the biddings of health insurance, and 2) billing and insurance-related matters take up the bulk of a traditional doctor’s time.
Dr. Ryan Neuhofel, a family care physician who transitioned to concierge medicine, immediately rediscovered his passion for his calling after making the switch. “I saw that most American family physicians did not have fulfilling careers; they spent enormous time in administrative tasks rather than actually working with their patients. I knew I wanted to do primary care but it had to be in a model that let me earn a decent living yet let me give real quality care in a compassionate manner.”
In concierge medicine and physician burnout, the former is proactive in reducing administrative burden on physicians.. This is because all coordination is accomplished directly between doctor and patient – medical transactions, specialist referrals, and everything else in between.
Moreover, cutting out medical third parties significantly reduces health care costs. A 2020 analysis by Peter G. Peterson Foundation reveals that American health care spends over $1,000 per person on administrative costs – that’s more than what it spends on long-term care at $973 and five times more than the average spend of other wealthy countries like Switzerland, Germany, and France.
In a 2010 report, the National Academy of Medicine (NAM) estimates that the U.S. spends twice the necessary amount on billing and insurance-related (BIR) costs, with administrative surplus amounting to a whopping $248 billion annually.
So what happens to all these moolah when administrative tasks stop being outrageous? In concierge medicine, these figures are factored in as physician and patient savings.
On the side of physicians, they are now able to run their practices with a leaner, more effective team that is focused on providing quality patient care. Concierge medicine practices typically need 1-3 employees to run smooth, patient-oriented operations – a stark contrast compared to the battalion of staff needed to fulfill traditional, insurance-based health care operations.
A 2015 study by Professor David Cutler on international medical costs shows the United States having 44% more administrative staff compared to Canada. The report also details that U.S. physicians dedicate about 50% more time on administrative tasks.
Patients, on the other hand, reap the benefits of more affordable primary care without the presence of third parties like health insurance. A report by Comstock’s Magazine shows that the cost of traditional insurance plans averages to $328 per month. This is much higher compared to $150 a month for concierge retainer fees plus a bare-bone premium for a high-deductible plan at around $110.
In many respects, the appeal of Concierge Medicine is that it resolves a fundamental shortcoming of the traditional, insurance-based system, which doesn't give physicians and their patients enough time for preventive care.
Managing chronic conditions and keeping potential illnesses dormant require countless patient-doctor conversations. They require a genuine, tight-knit doctor-patient relationship that has the patient’s best interests at heart. 15-20 minute appointments once or twice a year just doesn’t cut it.
Specialdocs’ “State of the Concierge Physician” 2019 survey shows very telling results. 90% of concierge doctors who participated in the survey cite that the additional time they have to develop relationships with their patients is the most satisfying benefit of concierge medicine. At 57%, enhanced work-life balance comes in second when it comes to the key factors physicians appreciate in the concierge medicine model.
Terry Bauer, CEO of Specialdocs, says, “Behind the numbers is the human face of concierge medicine – a joyful return to a physician-patient relationship built over time with trust, respect and extraordinary care.”
On the flip side, if your apprehension about concierge medicine is that you might feel even more burnt out because patients have access to you 24/7, then the reality will leave you pleasantly surprised.
Take it from Dr. John Kihm, MD, a concierge internal medicine physician. “Taking calls has never been easier. First, with fewer patients [in my practice], calls decrease in proportion to the number of patients. Second, the very patients who respect and value me enough to subscribe to me demonstrate discretion in calling after hours.”
When doctor-patient relationships are developed and maintained, there is a lot of respect and compassion that goes around. Interactions are no longer transactional. Dr. John Kihm adds, “Mutual respect is the norm in Concierge Medicine. Inappropriate calls come few and far between, so 24/7 calls are not hard.”
In the aspects of concierge medicine and physician burnout, what physicians come to terms with is that they cannot change the problematic traditional system, albeit they can take measures in reducing physician burnout through practice management changes.
Direct pay practices like concierge medicine have transformed many practices into a version physicians are proud of. Lighter patient loads, knowing patients by their name – concierge medicine doctors now have the privilege to walk with their patients in their wellness journeys, celebrate medical wins, or even empathize with them in hospice and share their pain. This is the beauty of working in medicine after all.
A post-discharge survey entitled A Case for Compassion reveals that what matters most to a patient is not clinical competence, but a physician’s “compassion, kindness, and empathy”.
Apart from having more time to spend with their patients, concierge medicine also addresses burnout by granting physicians the time, space, and resources to grow in their calling.
Many concierge medicine physicians report that they now have the privilege to pursue interests related to their specialization, dig deeper into their advocacies, and even conduct home visits to their patients. In contrast to traditional, insurance-based physicians, concierge medicine doctors have a renewed love for their profession.
Because direct pay practices operate based on a retainer/membership model (think Apple Music or Disney Plus), physicians are no longer overwhelmed with the thought of filing insurance claims just so they can get paid. Membership-based medicine is known to help physicians with their income flow, giving them greater autonomy on how they manage their practice and extend care to patients.
As per the 2019 Specialdocs’ survey, “maintaining autonomy and independence” is one of the most rewarding benefits of concierge medicine models. “Our physicians report that the most rewarding aspects of working [in concierge models] are the ability to remain autonomous and independent while creating a medical practice based on their personal vision.”
The rise of concierge medicine models across America is the health care industry’s stakeholders way of saying that problematic insurance no longer has to be the sole currency of quality health care.
A study conducted by Mayo Clinic on physician burnout and professional satisfaction among traditional physicians reports that 54.4% out of the 35,922 participating physicians show at least 1 symptom of burnout.
With concierge medicine, doctors no longer have to suffer through outdated insurance billing procedures and sacrifice their patient advocacy. The success rates of DPC and concierge models implore that creating a healthy work-life balance as a physician should be a top priority. When doctors are inspired and well-rested, patients are satisfied.
To end this important article, it is also essential to note that burnout is still possible no matter which health care model you are in. The key is to catch symptoms early and to take proactive steps to ensure it does not creep up on a physician’s well-being.
If you have been used to an organization making career decisions on your behalf, the independence and autonomy of a concierge medicine practice can sometimes feel overwhelming. As you go through the day-to-day of concierge medicine operations, make sure to set long-term and short-term goals regarding your practice. This way, it is easier to celebrate milestones, measure progress, and clothe your practice with a sense of direction.
