Misperceptions and deceptions about Cash only Doctors

This post is placed here to address common misperceptions and perhaps even intentional disinformation about the working idea behind "Cash Only Doctors". Mods, please move if you feel this is in the wrong place.

Cash only doctors is an idea that has found a resurgence across America in the midst of all of the hype and beurocratic red tape surrounding "Obamacare".

Many doctors are resigning out of frustration, but some doctors have taken a different approach, and are moving towards a cash-only based service. Some call it concierge service, but whatever you call it, it is attracting roughly 25% of physicians.

The term "concierge medicine can be misleading, however, because many of these doctors find themselves serving patients with cadillac medical plans with high deductibles and copays, for whom the cash only visits are actually less expensive, to the unemployed, and even homeless needing medical care.

These doctors are even making house calls, are willing to come to a hotel room if you are from out of state, and the amazing thing is, in many instances, the office visit cost is less than the copay for some insurance companies! That's right, you can get a 30 minute to one hour, one on one visit with a doctor that is attentive, is listening, and that will work with you on preventative care.

The benefits of this type of system are many.

They have to hire less administrative staff to handle the reams of paperwork dealing with multiple insurance companies.

They are NOT required to share your personal medical information. You sign a privacy agreement, and all of your information is done the old fashioned way, written on paper, safe from prying, spying eyes. Your information is between you and your doctor only, no one else. There is no requirement for them to place your private information online, where it is open to possible hacking, snooping, and sharing with multiple government agencies and untold pairs of eyes prying into your private life.

Cutting out the middleman drastically reduces costs, allowing the doctor to pass those savings along to you. For instance, a regular office visit for an insured patient for a 12-15 minute hurried office visit can run 145.00. While a portion of that is a negotiated rate, the doctor receives a slow reimbursement of roughly 23.00. The patient copay varies, anywhere from 30.00 - 55.00. The doctor must pay multiple staff, malpractice insurance, rent, power bills, etc. In the end, the cost to the patient is higher, and the doctor may even end up PAYING money to see a patient! No wonder they are leaving in droves!

Multiple plans are available, from 1000.00 -5,000.00 a year, depending on your needs. Or, just pay by the visit. With these plans, you will pay your fee up front, then have either regular visits, or, unlimited visits, at no other charge. Included are many lab tests, included are also standard physicals, and gynecological exams, and some even include discounted prescription plans.

The government does NOT want you to know about these types of services, but for light healthcare users, most would highly benefit from a service like this by simply not taking Obamacare, taking the "fine", and self paying for necessary visits.

It is noteworthy however, that doctors advocating this type of service recommend that you take a policy, but only use it for severe illness when it is a necessity, as opposed to draining the copays and employer contributions, or HSA', if you have those types of plans.

It is even beneficial to people with chronic disease, such as Diabetes, high blood pressure, etc.

Because you pay up front, the doctor has almost zero cost for collections.

There are many articles available on this subject, but the main reason that I felt like bringing this topic to the table for discussion is the huge amount of disinfirmation that I have seen, ranging from the doctors are greedy and only in it for the money, to claims it costs even more than insurance.

While it is my opinion that these claims are bogus, hear it from the doctors themselves. Many feel this is a return to what medicine should be.

Not only are the doctors finding it more enjoyable to treat and care for their patients, the patients are enjoying a closer, more confidential relationship with a doctor they feel they can talk to, who has the time, and who they can reach when they need them.

More one on one contact with the patient. Real, confidential patient files with no government intrusion. 24/7 access to your doctor by cellphone, email, and walk-in visits with no appointment neccesary, and even housecalls. Never in a million years did I envision a return to housecalls.

So, check out this article, and let's have a discussion about the realities of a cash only doctor without the hyperbole and lies that have been surrounding this topic for many months. This may, afterall, be the solution that some of you are looking for.

If you are looking to do some of your own research, simply use your own favorite search engine, and look for "cash only doctor" in your city. For general information and links, leave the city search off.

In the meantime, I will provide a couple of links to get you started. Please at least do some general reading if you are unfamiliar with this topic before making rash comments.

Enjoy! I look forward to some great conversation!

www.medscape.com...

aaps.wufoo.com...

General disclaimer:

As with *any* other type business, always do your research before choosing a doctor.

I have to star and flag this because it contains so much truth. The computer programs and staff needed with special skills so they can bill the insurance company brings up the price of things. The nicer the doctors office and the more fancy things it has, the more is needed to collect to break even. Take all of that and tack a percentage on it for insurance costs of the doctor and the office and personel and see why costs are so high. A doctor does not take home nearly as much as people think. If they get a hundred ten grand a year after expenses I think they are doing good. Overhead is getting higher and higher for doctors, if they have three doctors in an office they need five people working there. I remember my doctor in the seventies. His wife was his secretary and billing person. He had a modest office close to the hospital and had about eight to ten customers a day. He also had patients in the hospital to visit It was 35 bucks to go to the doctor those days. If I was layed off in the winter without insurance I didn't have to pay, he said he makes enough when I was insured. I'd go in if I got hurt to have it checked and also if I had a illness that wouldn't go away on it's own. I didn't abuse the situation.

Think about his costs verses charges. His income was about three fifty a day, five days a week. I bet his expenses overall were half of that and of course, he took what the insurances paid. Nobody had a copay.

Technology is increasing costs of medicine. Insurance billing and confusion is getting too complex and is causing a need for another worker. Insurance costs for employees of the doctors are increasing a lot. Everything is spiraling out of control.....and the doctors are not making more in their pockets, they have more families to support. Everyone pays for this and doctors that are nice want to guarantee the continuence of their coworkers so many inappropriate tests are done throughout the country...It is getting like the TV show "House" where ten times the amount of tests are done which supports the medical field employees. This is nonsustainable, we need jobs producing things we consume, not jobs that cause our cost of living to increase. Medicine has become a big part of our Economy, it shouldn't be.

Last year I got ill and had to go to an Urgent Care facility and it cost me tons of money. A few months later the same problem reared its head because of vague direction on the part of the Urgent Care staff who seemed all too eager to move me along after collecting my payment.

So I decided to try something different and went to my "neighborhood doctor"... meaning she works out of a small studio behind her house. She is a legit doctor, but was fed up with all the costs mentioned in the OP. So now she only charges a small fee for a 30-60min visit and its WAY cheaper then going to Urgent Care or in some cases even a Co-Pay!

She actually spent the whole 60 minutes hearing my story and coming up with a plan to get me better!!!

In the case of some massive injury or accident then its probably a good idea to have some money set aside or health insurance... but for your basic run-of-the-mill office visits for a healthy young person, going to a small neighborhood doctor is the obviously better choice. You get more personalized care, more time with the doctor, and the prices are reasonable.

S & F

Libertygal
This post is placed here to address common misperceptions and perhaps even intentional disinformation about the working idea behind "Cash Only Doctors". Mods, please move if you feel this is in the wrong place.

Cash only doctors is an idea that has found a resurgence across America in the midst of all of the hype and beurocratic red tape surrounding "Obamacare".

Many doctors are resigning out of frustration, but some doctors have taken a different approach, and are moving towards a cash-only based service. Some call it concierge service, but whatever you call it, it is attracting roughly 25% of physicians.

This is not NEW nor because of Obamacare. Jeez, you'd think that history never existed.

I lost my doctor about 14 years ago because his practise went concierage. To continue to see him I would have to pay $1800.00 a year and I would get a promise that he'd be able to see me within 2 days. Nothing more. Still needed insurance for visits and tests. It was an upscale practice with a lot of elderly patients that did go for it. I'd been seeing him for years - but $1800.00 more a year for the privledges he was offering was unaffordable then.

The deal, as I see it is, Doctor's are no longer automatically rich. Going Cash means less admin costs and less staff and more profit for the practice. It used to be that Doctor's didn't go into the profession for the possibility of weatlh so much as for the good they could do. That changed drastically in the 70's and beyond.

That change plus the huge burden of debt that most new doctors carry from student loans makes them somewhat of an improverished class and it is just another example of the vanishing middle class.

I agree there are many benefits to seeing a doctor off the official insurance books for those that can afford it because insurance companies do collelate data from claims and share it with other insurance companies (where do you think Google, etc got the idea). There is no patient/doctor confidentiality on an insurance claim - all information on the claim becomes the Insurance Company's Propriatary Data to do with as they please.

Single Payer - Universal Care is a better answer to the privacy problem. The Data would still be collected. Collected health data would provide a wonderfully rich source for medical research but the data would, by law (REGULATION - a prime function of Government) be anonymised nor could it be shared with PRIVATE BUSINESS for marketing or red-lining purposes.

Such would provide for the COMMON GOOD and the individual welfare.

There are many other benefits to UNIVERSAL SINGLE PAYER systems as well.

Cash Only works if you have the cash. I don't and don't know many who do. A doctor can't do a lot without expense tests. (Diagnosing my High Blood Pressure ran about $15,000 - thank goodness I had insurance at the time - and still had to pay out-of-pocket about $1,000)

reply to post by FyreByrd

Please re-read what you even quoted in my OP. I stated it was a resurgence, not something new. However, the direction that some doctors are taking this IS new. That is why I urged people to read the article, first. Because of Obamacare, yes, this industry is seeing a resurgence, and many traditional doctors who had planned to go the hospital/office/insurance route are carving non-traditional pathways, and finding a lot of support.

Namely, these doctors are negotiating low contracts with laboratories, radiologists, etc., then are able to offer drastically reduced costs for things, such as diagnosing, and continuing treatment of high blood pressure and diabetes, chronic pain, and other chronic illnesses.

From what you stated that you have experienced, perhaps researching a new doctor would be appropriate, as the costs you described are hugely above what is being discussed in the article.

Basically, that was then, and this is now. Doctors realize that the system is overpriced, and are doing everything in their power to bring affordable healthcare to their patients, instead of the insurance companies and profiteers. They are talking about 200.00 MRI's, not 2000.00 ones, when we all know full well those machines were paid off within the first month after purchase.

I provided the article, as well as a list of physicians of all kinds, so if you did not read the article, perhaps you should. It is highly informative, and, discusses what is happening now.

In the past, I went self pay also, but it was not through a doctor such as the ones discussed in the article. It was an insurance based clinic, and I had none. I self payed the going rate also, which was exhorbidant. Had I known this type of place was available, I would have likely gotten better health care at a much reduced cost.

These doctors also provide negotiated rates for surgeries that include the hospital, anesthesiologist, and meds, at rates that beat most insurance company negotiated rates. One article quoted a doctor that provided a 40,000.00 hernia operation at a negotiated final bill of 5,000.00. At the costs I am seeing above and beyond my monthly premiums, based on a 90/10% copay, depending on what my insurance negotiated rate might be, I could possibly end up paying less at a negotiated rate with a doctor such as this than my insurance can provide me!

And, that 90/10% only kicks in after I have paid 6500.00 out of pocket deductible. I would use the self pay, not use my employer contribution debit card, and turn in my expenses as a part of meeting my deductible. This way, if and when I may need emergent care, it will be there. Then again, I am a heavy health/med user. So, different things for different people. That is the whole point, this is tailorable to fit so many lifestyles. Wealthy, middle class, and even lower class poor. When you cannot find a doctor who will accept Medicaid in your area, it leaves you a choice of a regular self-pay clinic at 145.00 visit, or perhaps a doctor out of the "system" that will see you and provide discount meds for 20.00.

Please, everyone should read the article.

reply to post by rickymouse

Some great points in your reply, thank you! And, let's not forget too, they still have huge college loans they have to pay off. What used to be around 125,000.00 med school debt is now topping out bewtween 250,000.00 -300,000.00. There will be no government help for these doctors, they are being left to their own devices to figure out how to repay these debts in a hugely declining income.

Speak about specialists, particularly neurosurgeons, they have more debt due to longer schooling, higher than average malpractice insurance, and overall higher overhead, and tou have a rapidly declining count of an already hard to find physician.

Many have no choice but to practice under the umbrella of a hospital because of the high tendency of a sue-happy culture that is out of control. Neurologists and neurosurgeons are among the most sued, and hardest to defend. Their costs in overhead alone almost negate their income. I know, I work with quite a few.

Thanks again for the input!

reply to post by henryleo


Thanks for sharing your story. Don't you find it ironic how quick people are to rant on corporations the likes of Walmart shutting out "mon and pop" type stores, but we hear nothing of these insurance moguls literally burying self-supporting doctors?

I say good on them, especially when they are going out of their way to get lab and radiology reduced rates. I love the idea that I can go to the doctor every 3 months for my required visits for diabetes and low thyroid, and my labs AND doctor visit will cost me a total of 40.00 - 50.00. That is less than my current HMO copay, and I can get the generics for 3.00, as opposed to the 10.00 copay. It is a win/win for me and the doctor! I even found out that Publix Supermarkets are providing antibiotics at 2.00, so if necessary, that's even better!

I get a mandatory flu shot at work, but even if I did not, and wanted it, it is considered preventative care, and free with zero copay through my insurance.

I just see this working well for a lot of people.

Thank you for sharing!

reply to post by Libertygal


Yeah my doctor also helped point me to a low-cost lab (that she has a personal relationship) with so that I could get cheaper tests done... she saved me HUNDREDS! Which is a lot for me because I am very much broke ;P

I agree about the mega-chain retailers getting a lot of attention (as they should!).
But I think people dont see the health-care industry in the same light because (in their minds) they lump basic or preventative care in with IC and ER facilities. These huge buildings that can handle all manner of illness or injury (which I think is great!). But the bulk of basic health care can be handled by a single well-trained individual with a few specialized tools... in a cool looking bag... wearing a cool coat!

I for one love when people take a horrible situation (like our current health-care system) and actually start heading for something better - like these neighborhood micro health networks!