July 13, 2021
Why is there a membership in New York City? Managed-care has not been kind to doctors. In fact, it has not been kind to patients, either. Reimbursements dropped significantly over the past few years. Some essential services stopped being covered. I was losing money, in an attempt to practice the way I thought patients deserved. Most practices implemented very short visits and started hiring NP’s and PA’s; they were making up the difference in volume. Patients were spending thousands of dollars in health insurance, seeing a health care professional for 15 minutes and possibly not even their doctor! I didn’t want to practice medicine that way. In 2019, I implemented a membership fee in the Manhattan office, while still accepting insurance for every visit. . It was a way to keep the practice afloat and not abandon my patients or my own moral agenda. I’m thankful to say, it was a huge success! Then came COViD. Most don’t know that, as health care professionals risked their lives, the government dropped reimbursements even lower, while not providing them with PPE. As an Infectious Disease doctor, my expenses were huge. I then had to raise the membership, making sure to still keep it affordable to my patients. Did we do this well? Maybe not. My policy became, there is a the membership fee, but if you truly can’t afford it, we will not send you away. A few new patients thought we were bargaining or “haggling”; we were not. I couldn’t turn away patients I’ve known for years and developed a close relationship with, if the fee was a financial burden to them. After two bad google reviews related to this policy, I learned, no good deed goes unpunished. So much for kindness. Our practice continues to thrive and the membership fee is now fixed. For those who can’t afford it, I am truly sorry. Concierge in Westchester? Honestly, I never thought I’d do this. I didn’t became a doctor to become rich. I did it for the love of medicine. So why concierge? Another lesson from the COViD pandemic. I was approached by a wonderful pediatrician in Westchester, practicing that way. He was giving his patients long visits and going to their homes. He told me that he became part of their family, joining them for a meal and learning about their lives. He said the parents wanted a doctor like that, too, but he was a children’s doctor. He asked if I would be interested in seeing some of the adults. That is how Scarsdale Health & House calls was born! I saw my first concierge patient yesterday. An elderly man that was home bound and thus couldn’t get to doctors. The family welcomed me into their home. I spent two hours with them, getting to know my new patient and figuring out his needs. Time consuming? Yes! Worth it? Absolutely! I feel good that I have helped a man, who otherwise wouldn’t have gotten help. For those of you who have read this, thank you for doing so and be well!