Physicians Abandon Insurance for 'Blue Collar' Concierge Model

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Compliments of US News & World Report

No insurance? No problem.

A small but growing number of primary-care physicians has stopped taking insurance — and they may be radically reshaping how American families get their medicine.

“We’re running a business that’s profitable and caring for patients the way we’ve been trained to care for patients,” says Dr. Jonathon Izbiciki, owner of Izbicki Family Medicine in Erie, Pa. “We have our voices back, and we’re masters of our profession. There’s nothing better than that.”

For years, the no-insurance — or “retainer” or “direct-care” — approach was almost exclusively reserved for the wealthy. Specialists or physicians who catered to deep-pocketed patients would charge a lofty monthly “membership” fee, and in exchange, offer “luxury” amenities like same-day appointments, little to no wait times, more time with the doctor and consultations by phone, email, Skype or even text-message.

But with industry changes looming and the implementation of the Affordable Care Act bringing an influx of newly insured low-income and Medicare patients, some primary-care and family-practice physicians have set out to change this so-called “concierge” model: in short, by offering the very same services at a mere fraction of the cost.

“We’re like the blue-collar concierge,” Izbicki says.

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Unintended consequence? Nope, there was plenty of warning

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As the Affordable Care Act continues to roll out, it is important to keep in mind that multiple physician organizations have warned that the upcoming demand for physicians exceeds the supply.

The Maine Osteopathic Association has been pivotal in attempting to educate the various State and Federal agencies about this.  Unfortunately, it has fallen on deaf ears. 

A recent article by the Journal of the American Medical Association highlights this present, and worsening, quandary.  The conclusion says it all:

 "The Patient Protection and Affordable Care Act (ACA) is projected to expand insurance to an additional 25 million Americans.  Although these expansions are intended to improve access to care for the newly insured, it is not known whether the primary care system can accommodate the increased demand, nor is it clear whether the system meets current demand. Several studies have raised concerns about our current primary care capacity, particularly for Medicaid patients. Given that access to primary care is considered a prerequisite for improved population health outcomes, a strained primary care system may place many of the goals of the ACA at risk."

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