Updated September 26, 2019. As questions arise around the future of health insurance in America, it’s a great time to reevaluate how we administer health care. Medical centers are strapped, wait times to see doctors stretch out, and it’s harder for people to get the treatment they need. The days of the family doctor who would make a house call are long gone.
Or are they?
Concierge doctor services are back in style — at least for some people. An article in The New York Times recently highlighted the staffs and patients of high-end medical centers like Private Medical Group and MD Squared. Concierge doctor services often cost more in a year than most people’s annual salary, and premium medical facilities are like luxury hotels with bedpans.
These are great services for those who can afford them. But what do they mean for how we look at the country’s health care system, and what options are out there for patients who can’t afford to pay tens of thousands of dollars for house calls?
A new batch of startups is trying to provide answers by using technology to offer some of the same personalized service without the exorbitant prices.
The benefits — and concerns — around high-end care
Premium patient care is exploding in two areas: concierge doctors, and high-end medical facilities.
Concierge doctors are at the beck and call of only a few select people or families. These private, on-demand doctors will see you in their office, or go to your home or your own workplace. They’ll go above and beyond, making sure families have the proper resources wherever they are. And they’ll use their connections with other doctors and facilities to make getting treatments better. "I don’t know if I can get you to the front of the line," one doctor told The New York Times, "but I can make it smoother."
And the hospitals? Lenox Hill is where Beyonce gave birth to Blue Ivy; the hospital also hired a Louis Vuitton designer to create an upscale experience and serves rack of lamb. That’s a little different than the green-flavored jello most of us are used to during hospital stays. Private rooms might be preferred for many patients, but they come at a cost.
Proponents of this system argue for the benefits it has to both doctors and patients. Doctors avoid burnout by limiting the number of patients they see.
But they’re also able to give those patients more care and attention. Instead of seeing a dozen patients before lunchtime, doctors can spend time with patients and dig to the root of issues. Rather than herding people in and out of rooms, doctors can do research and talk to specialists to give their patients an in-depth level of care that isn’t logistically possible otherwise.
But there are still moral issues that arise in this system. Yes, other industries have tiered services where people pay more to get more, but should health care really work like that? This is people’s health – maybe even their lives – at stake. Is it fair to people who can’t afford white glove service from their doctor? A patient interviewed by The New York Times even recognizes the conundrum: "I feel badly that I have the means to jump the line… But when you have kids, you jump the line. You just do. If you have the money, would you not spend it for that?"
In an ideal world, there would be no line to jump. We’d have a health care system that did away with high costs, redundant procedures, and poor service. We don’t have that system. There's an argument to made that the fancy rooms and racks of lamb serve a larger purpose, subsidizing the costs of a system even for people who can't afford the luxury trappings. But ultimately our system isn't one of equality. Do we work towards it – or just try to make the concierge model more accessible to everyone?
Concierge health care for the masses
As in many other cases, tech has stepped in to "disrupt" a business model. This time, it’s through app-based concierge doctor services. This isn’t telemedicine, where you may get paired with a random doctor that isn’t much better than just looking something up yourself on WebMD. These are actually doctors who know you and your health history. You may never see them in person—but they're available by text and video chat anytime, offering you the same kind of personalized service as traditional concierge medical services, except digitally.
SteadyMD is one of the companies leading this charge, offering "ongoing, continuous, dedicated primary care online." They even have doctors with focuses in fitness and lifting, functional fitness, and LGBTQ health. SteadyMD promises same-day virtual appointments with your doctor, whenever you need him or her. HealthLoop is another company trying to expand the space, and OneMedical has an app you can use to speak to doctors to go along with their physical locations.
These services offer a monthly or annual membership fee, but nowhere near as much as the "elite" services. You can often get care for under $100 a month, and almost always at least under $200. This is compared to the $40,000 you can easily spend on a concierge. It’s not always the same as hands on care, but not everyone needs that. Virtual doctors are able to diagnose, prescribe, and refer you to a local specialist for a procedure if the need arises. These services can also recommend a primary care doctor from their doctors so you’re given some direction, rather than searching blindly for someone to help – or, worse, ignoring a problem altogether because you don’t know where to turn. Some people may choose to pair a primary care service like SteadyMD along with a low-cost, high-deductible health insurance plan for emergencies. The combination may give customers more personalized service and cover them for procedures at a fraction of the combined cost of traditional concierge medical service.
(As for bringing luxury hospital suites to the masses - well, there's not much an app can do about that.)
The future of health care – or even health insurance – is unknown. But, by its very nature, providing expensive, exclusive services will only help a small percentage of people who need medical care. The idea behind concierge doctor services, that people deserve time and attention from medical professionals to get the best care possible, is a good one. Now we only have to hope that apps like SteadyMD can help proliferate that care to people who don’t want to take out a second mortgage on their house to get it.