Boutique medicine…

My personal physician, an internist, is what is known as a "boutique" physician.  As his patient, I pay him a flat fee of $1,500 per year, and in return I get 24×7 access to him.  I have his home phone number, cell phone number and email.  When I want to see him, I speak with him directly and make the arrangements.  He will also make housecalls.

I love this arrangement on so many levels.  First of all, I have a modified health insurance plan that excludes any primary care provider coverage, as I don’t need it.  It covers medications, specialists, lab tests, hospitalizations, etc., but doesn’t have to deal with primary care office visits.  And the annual premium reduction is MORE that the $1,500 I pay him.

He only has 500 patients, so he makes a good living at this arrangement ($750,000 a year), and I never have a problem seeing him.  When you average it out, his daily patient load is less than 2 patients a day in a 5-day work week.  Talk about quality of life!  And he doesn’t have to maintain a large staff of receptionists, claims managers, etc.  Nor does he answer to the insurance companies about how he practices medicine.  He does what is best for the patient.

This model may just save primary care medicine.  Most family medicine, internal medicine and general practice physicians make a lousy living (about $175k).  There is a huge patient load, high stress and very little financial reward.  That’s why there is a shortage.  If you’re going to make all that effort to go through school, you may as well become a specialist and make good money.  A boutique practice offers a reward for providing a critical service, and will result in having more practitioners.