A combination of rising costs and low insurance reimbursements is forcing some primary care physicians to opt-out of the insurance game completely — accepting a flat fee instead of private insurance or Medicare. For a $4,500 annual fee, patients who formerly used their insurance to pay for doctor’s visits can get 24-hour access to doctors, unhurried appointments, home visits and state-of-the-art annual physicals. Or they can find another doctor.

From the Baltimore Sun:

Diana Moore learned the news through the neighborhood grapevine. Her family’s primary-care physician of seven years would no longer accept Moore, her husband and daughter as patients – unless the family paid a $4,500 annual fee.

The physicians at Charter Internal Medicine in Columbia are overhauling the practice, ditching the insurance-dependent model and instead charging a flat yearlyfee in exchange for the promise of 24-hour access to doctors, unhurried appointments, home visits and state-of-the-art annual physicals.

Known as “boutique” medicine or “concierge” care, the national trend appears to be sweeping across Maryland as primary-care doctors feel the financial crush of rising costs and low insurance reimbursement rates. Physicians say the model allows them to trim their patient loads and give patients quality care without worrying whether insurance will cover it.

“Primary-care doctors are seeing 30 to 40 patients a day – that’s too many,” said Dr. Harry A. Oken, who has been with Charter Internal Medicine for more than 20 years. “It’s not about the money. It’s about having the time to spend with your patients to keep them healthy.”

There’s already a shortage of primary care doctors, and they’re not as well compensated as specialists.

“Doctors have nowhere to turn but to try to find a different business model,” said Dr. Ronald Sroka, president of the medical society, known as MedChi. “Some people want more than their insurance company will provide, and some people are willing to pay for this additional service.”

Sroka, who practices in Crofton, said that after paying salaries and expenses, he makes about $15 to $20 an hour. He said he’s not sure if he can last more than another year or so, working some 80 hours a week to keep up with his bills.

For those of you thinking of finding a “boutique” doctor, keep in mind that you’ll still need insurance. Hospital stays, blood work and ambulance rides are not included.

For a little more, the doctor will see you now [Baltimore Sun](Thanks, Robert!)
(Photo: Getty)

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