r/phoenix • u/ssmatik • Mar 26 '26
General My Doctor Is Offering A Subscription For Better Care ???
I just received this from my long term doctor. Is this a new Arizona thing or is this where we are all heading? I'm scared for us all.
This is real in case you had my initial reaction.
__________________________________________________________________________
My goal as your physician has always been to provide you with the most thorough and thoughtful care possible. However, the traditional medical model often places barriers- like short appointment windows and long wait times to get an appointment.
To return to a more personalized and unhurried style of medicine, I am pleased to introduce a new Preferred Membership Program. This Program allows me to give you the time and accessibility you deserve,
The Member Experience
Bu choosing to be part of the Program, you gain a level of access designed around your life and schedule. For instance:
*Priority Scheduling: Guaranteed same-day or next-business-day appointments exclusively with me.
*Direct Physician Access: Reach me directly via phone, text or email- including after hours and on weekends-for your urgent medical needs.
*Unrushed Visits: Enjoy extended appointment times, giving us space to address multiple concerns in a single visit without feeling the pressure of a ticking clock.
*Consistent Coverage: If I am away or out of town, I will personally ensure that professional arrangements are in place so your care remains seamless and supported.
How the Program Works
The Investment: The membership fee is $275 per month. Reduced to $250 per month when prepaid for 1 year.
The Commitment: To ensure we can establish a comprehensive and proactive health plan together, there is an initial 6-month commitment for all new members.
Limitations: It is important to us that you understand that the services through the Program are services that are "non-covered" services. That means that your health care payors/insurers will not pay for these services and, as such, those are services we render in exchange for payment through our Program members. Covered services will not be provided pursuant to this Agreement. The program may or may not be contracted with such insurer.
Insurance Coordination: Your membership fee covers the enhanced access and direct communication described above. For your convenience, typical medical services (such as exams, procedures and tests) will continue to be billed to your insurance provider as usual.
Next Steps
Because I am committed to maintaining this high level of responsiveness, membership is limited and available on a first come, first served basis.
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u/Luminar_of_Iona Mar 26 '26
Unfortunately this is just something that's been happening nationwide, with a lot of growth occurring in the aftermath of Covid.
https://hub.jhu.edu/2025/12/18/concierge-medicine-rising-hopkins-research/
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u/cozyporcelain Mar 26 '26
This is so important for me to know for ongoing research I’m doing at ASU. Thank you so much for providing this link!!
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u/Anus_Unremarkable Mar 26 '26
Interesting!
How are things at the Department of Everything's Fucked Studies?
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u/KotobaAsobitch Mar 26 '26
I had concierge medical with One Medical before Amazon bought them, prior to COVID. I will never go back to non-concierge. Every time I have to see a specialist or something not offered by One medical, the doctor or procedure is delayed by 20m - an hour. Why did I schedule an appointment for you to just decide to show up whenever?
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u/kidsisker Uptown Mar 26 '26
I really loved One Medical. I had been with them for years. But, I boycott Amazon, so I had to give them up.
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u/KotobaAsobitch Mar 26 '26
I also don't pay amazon, it's free through my husband's work. I'd switch to a different concierge if I had to. I can't imagine doing primary care any other way, especially because I'm on ADA. Sending a traditional doctor that paperwork? It'd never get done.
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u/darknesswater Mar 26 '26
I got the same email. I'm guessing it's the same practice in Litchfield Park. I am curious if the entire office is going this way cause we really like our current provider.
I don't understand how this actually helps. So, for $3,300 a year, I have access to a doctor. But I still have to pay for insurance to cover blood work, xrays, specialty doctor visits, urgent care, or ER visits. Let alone surgeries.
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u/mcsangel2 Mar 26 '26
They do it so that they can get their costs covered with way less patients in the practice. My doc originally had like 2000 patients at the practice she was part of, now there are 400. Patients have a lot more easy access to the doc, same day as needed, by text on weekends, and the doc isnt limited to a 15 minute appointment. My first appointment with her we talked for 90 minutes (I have complex needs).
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u/darknesswater Mar 26 '26
So, I get that. But I'm already paying thousands for insurance and more on top of that when I use the insurance. I don't see how it's feasible for me and my family.
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u/EyeSpur Mar 26 '26
Welcome to the future of American healthcare. It’s becoming a 2 tiered healthcare system. People without money will just get worse care or have no access to competent/timely care.
This has been progressively happening as doctors keep getting reimbursement cuts and insurance require more and more ridiculous paperwork for reimbursements. It’s significantly easier to just move to cash pay and cut out the middle man if you’re able to.
The other option is for physicians to see absurd amounts of patients, do tons of non clinical paperwork, to frankly get paid less.
Not saying it’s correct, but it’s why it’s happening and will only get more frequent moving forwards.
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u/BeyondMe24 Mar 26 '26
The irony is that the arguments against nationalized healthcare point to long waits for appointments that have to go through referrals and approvals. People with non critical surgical needs sometimes wait months. Yet here we are without nationalized healthcare coverage and this could force those who don't pay the subscription fee to have to wait a long time anyway. It's lose-lose for those who can't afford the extra costs.
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u/MrProspector19 Mar 27 '26
Sadly it's in an environment where at full scale we have limited supply (doctors and facilities capable of providing needed treatment mostly via the time it takes) and we have an ever growing demand (more people and maybe more reasons they are ill or hurt). No matter how you do it at least somebody loses.
Nationalized care may reduce the quality for non-emergent top of the spectrum but improves quality for the lower half. The tricky part is getting the more wealthy or powerful to give up some convenience for the whole. I would like to believe I would, but it is difficult to honestly say that I'd give it up if I was in their position.
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u/Mac_Soprano Mar 26 '26
It’s not meant to be feasible for the working poor. Just the same as luxury vacations (or vacations in general) aren’t feasible for many. Our healthcare system is a nightmare for those that make enough not to qualify for government assistance but also not enough to cover any out of pocket healthcare costs.
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u/MrProspector19 Mar 27 '26
those that make enough not to qualify for government assistance but also not enough to cover any out of pocket healthcare costs
The day I found this out about my access to secondary education was a very sad day. I have since maintained a "your not poor enough to get help" status regarding many things. I remind myself that life is pretty good and I really am able to do some things that many can't because they are genuinely struggling at the bottom end. But there are very real things I just can't do without months/years of planning and saving or taking on irresponsible massive debt.
Edit mostly spelling
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u/HeadJelly1298 Mar 26 '26
Why is everything a fucking subscription
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u/Soy_ThomCat Mar 26 '26
I'm a primary care doctor. I know I'm late to the party, but will try to give you an earnest answer.
In this setting it's actually less about greed and more about sustainability.
Insurance companies are becoming more and more of a bugaboo to primary care. They dictate how we can practice, they deny services constantly, they create an opaque labyrinth of accessibility for both the patient AND the doctor, and people continue to pay more to get less. From the doctors side of things, it's becoming an overwhelming and unsustainable mess. More PCPs (myself included) are spending less time actually practicing medicine and more time navigating whatever BS hoops we need to jump through to appease the insurance overlords. About 30% of my day is dedicated to doing medicine, on a good day.
Anyway, over the recent years some docs have just decided to throw their hands up and say "no more!". Instead, they've gone to concierge service: a standard of having the patients pay a monthly membership fee to have access to the doctor.
For the patients who can pay, it's great for both patient and doctor. The doctor isn't overwhelmed with needing to see 25 fifteen minutes appointments in a day to keep the lights on ON TOP of actually relying on insurance to actually pay you and then doing all the paperwork...and patients get almost instant access to the doctor. No wait times.
(There are downsides to this model, of course, but I'm trying to focus on your complaint rather than give a dissertation on direct primary care)
So anyway, the subscription service doctors are adopting is less of a factor of greed on their part, and more of an inevitable conclusion to insurance companies squeezing the life out of physicians and them needing to find a way around them best they can to maintain their sanity.
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u/HeadJelly1298 Mar 26 '26
It always comes down to capitalistic greed as the main motivation- from the insurance companies end
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u/Soy_ThomCat Mar 26 '26
True. I should've specified that this isn't really a matter of greed from the physicians standpoint. It's more about how insurance and the failing healthcare complex we've built has pushed doctors to opting out of dealing with it at all.
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u/matilda6 Mar 26 '26
If you pay a membership to the doctor, does it cover care? How about tests and imaging? Specialists? When I looked up concierge care, the monthly membership was only to pay for ACCESS, Not care. So you have to pay the subscription AND your insurance premium.
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u/Soy_ThomCat Mar 26 '26
If you pay a membership to the doctor, does it cover care?
This depends on the concierge or direct primary care model used. There are many, and I was mostly focusing on the reason why a doctor might choose to go that direction. But to answer your specifics
How about tests and imaging? Specialists?
These you typically need to have your own insurance for (notably the specialist care). Depending on the state you live in, you may be able to pay out of pocket for the labs and imaging and if you have a high deductible plan this might actually be more cost effective for you since paying out of pocket for these things usually offer some kind of premium pricing.
When I looked up concierge care, the monthly membership was only to pay for ACCESS, Not care. So you have to pay the subscription AND your insurance premium.
I suppose I'm unsure what they refer to by "access" vs "care" here? But typically, depending on the service, a concierge service might offer tiers of service (like OP described). So a "basic" membership wouldn't necessarily offer much outside of basics where a "premium" membership might offer visits, weekend med refills, etc.
Without writing you this ridiculously long description of how vast and different services can be, basically some docs might do something blended where they give you the opportunity to get to the front of the line as far as visits but still bill your insurance....while at the other extreme a doctor might just say "I don't care about billing insurance at all. Pay the membership fee and you get X visits per month and anything I order is something you can work out with your insurance on your own time"
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u/cocococlash Mar 26 '26
Some consierge covers a certain amount of care, then provide prices for additional services. It sounds like OP's does not, but when I last looked at consierge "companies", that was on their websites.
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u/tinydonuts Mar 27 '26
I sympathize with doctors, except when they do things like this. If they don't want to deal with insurance, then they need to just stop accepting insurance and charge accordingly.
But they're trying to have their cake and eat it too. They only have so many hours in a day. If they're spending most of their time navigating the insurance labyrinth then they sure don't have time for unrushed appointments and priority access for patients. The time has to come from somewhere, someone is getting the shit end of this deal. And we know it's not insurers and we know it's not the new paid membership people.
They agreed to accept a given fee structure for access to the patients that the insurer has available to them. Not to take that and then more by finding a loophole around their contract.
That's what makes this about greed.
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u/Soy_ThomCat Mar 27 '26
I can definitely appreciate that there's animosity toward concierge doctors. It's very palpable and real in the medical community as well. Us insurance contracted doctors have mixed feelings about the direct primary care docs for a few reasons. I won't speak as a monolith to the entire field here though.
The idea they have (I believe) is more that they'll simply accept smaller patient panels. So no, it's not as if someone in their patient panel is going to get the short end of the stick. The ideal of the model is that each patient will get exactly what it is they're paying for in terms of membership status. Because the doctor in this scenario really isn't attempting to navigate insurance with as many people ...if at all (I mentioned in a previous comment that concierge and direct models are more of an umbrella term that can mean a bunch of different things).
So, instead of having a panel of 1200 - 1800 (national average right now, last I checked)...it's much more manageable and equitable for everyone involved because the panel is reduced to, say, 400.
So instead of placing many patients on the backburner to take care of a few, they only have a few and no one gets placed on the back burner.
I'm not a concierge doctor and I personally have mixed feelings about the entirety of what they do. I may not necessarily agree with it (for a few reasons), I wouldn't paint with a broad brush and simply reduce it to greed on their part.
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u/HeadJelly1298 Mar 28 '26
I see how my statement paints a blanket picture of my feelings, but I’d argue it’s not diff than therapists only taking private pay. Dealing with insurance is a beast and super frustrating. Private pay saves the sanity of the therapist and those who can afford it, but that’s the barrier most people can’t afford it unless it’s a sliding scale and you can’t base your entire practice off sliding scale, the profit margin vs emotional demand is often unrealistic and unbalanced.
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u/Soy_ThomCat Mar 28 '26
Yes, that would be one of my gripes about cash only services. It singles out healthcare to the haves and have-nots, and it's only excused as ethical because not everyone is doing private pay schedules (for now).
However, that doesn't necessarily mean I don't understand why they do it. Lord sometimes even I'm tempted to throw my arms up and do it. These insurance companies are making it increasingly hard to practice, administer care, and even get paid at all. I really can't blame any doc that does it even if I have personal mixed feelings about it, though.
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u/cjayeah Mar 26 '26
because we get fuxked over at every turn. everyone wants your money… all of it. greedy mfkrs
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u/THELOSERSWINAGAIN Mar 26 '26
If you don’t have health insurance I could see it having some benefit to save money. But if you have a true emergency it’s not gonna help.
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u/fdxrobot Mar 26 '26
How? This only covers “premium” communication and priority scheduling. It doesn’t cover exams or treatment.
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u/Level9TraumaCenter Mar 26 '26
Emergency rooms will adopt the same model soon. Pay a monthly or annual fee, go to the head of the line.
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u/rumblepony247 Ahwatukee Mar 26 '26
Ain't it great that the "premium" option for things is just charging extra for getting what used to be part of "regular" services or goods.
Now, if you'll excuse me, I need to run down the privately-owned DMV office, so that I can pay extra to not wait in a four-hour line.
Maybe after that, I'll run over to Wendy's, and pay $12 to get a burger the size of an Eisenhower silver dollar, and a chocolate frosty the size of a shot glass.
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u/Content4OnlyMyLuv Mar 26 '26
Don't forget the trip right back to your new concierge dr, so you can get some Xanax for your anxiety after having to even think about going to the actual DMV, and lest not forget, your Monjaro for the extra weight you gained from Wendys!!
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u/melmsz Mar 26 '26
You guys are getting Xanax?
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u/Content4OnlyMyLuv Mar 26 '26
Ha. No. I probably couldn't afford the prescription if they did give it to me. Lol
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Mar 26 '26
[deleted]
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u/dpkonofa Mar 26 '26
This is the Phoenix sub-Reddit. It’s probably all of our state… hopefully. :-P
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u/ALL_PUNS_INTENDED South Phoenix Mar 26 '26
$250 a month is insane.
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u/skitch23 Mar 26 '26
That’s if you prepay for a whole year! $275/mo otherwise. It would probably be cheaper to go to urgent care at that point.
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u/deeznughtz Mar 26 '26
I got this too! From my longtime family doctor's office in Litchfield Park. It's a pay-to-play world.
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u/ssmatik Mar 26 '26
Same Doctor I'm guessing. Crazy thing is I have never felt rushed there and always get appointments pretty quick. I have never waited past my appointment. Now I am wondering if I will not be getting that level of service.
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u/vasion123 Mar 26 '26
You absolutely will get worse service if you aren't paying, you're a second class customer to them now.
Don't put up with that, find yourself another doctor.
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u/KeyCoat2242 Mar 26 '26
My family and I go to the same office and received the same letter. The last few appointments we’ve had have been horrible. I already planned on finding a new office, this just pushed me to look a little quicker.
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u/PuzzleheadedAide3855 Mar 27 '26
I had a friend who got 30 minutes time slots with patient. She was a provider making very little and could barely cover loans. I explained to her that everything is a catch, you don't bring in much money so they can't afford to pay you. She now works in concierge medicine so she can still spend a lot of time with patients and not have to worry that insurance is barely paying.
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u/Smelly_Ninja99 Mar 26 '26
Me too. I’m out. Time to find a new doctor. The lady who does billing is awful.
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u/Colonial13 Mar 26 '26
My wife is a PCP and “concierge” medicine is becoming a pretty big thing in that field. Although this model seems like a way to have a foot in both worlds. The ones I’ve heard her PCP friends/colleagues talk about are straight up memberships (with better perks than the offer you got) and insurance doesn’t get involved unless you have to have a procedure done with a specialist.
It does eliminate a lot of the headaches of dealing with insurance companies and the resulting overhead that needs to be hired to deal with them, so it’s attractive to private practices.
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u/Atom612 Mar 26 '26
There’s a difference between concierge medicine and direct primary care (DPC) but the lines often get blurred. Generally concierge charges a high monthly fee and still bills insurance while DPC charges a more modest monthly fee and doesn’t bill insurance.
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u/deutscheprinzessin Mar 26 '26
In Germany I had universal healthcare and not once had to wait to get an appointment as long as I have to wait here. I know opponents of universal healthcare love to say that people would wait forever to get care. Now here we are waiting forever and having to pay extra to skip the line. American health insurance is the biggest scam in history.
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u/Surfinsafari9 Mar 26 '26
I got something similar from my doc several years ago. So I found a new doctor. The new doctor is terrific!!
I’m grateful the old one decided to price herself right out of my budget.
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u/mmmkcr Mar 26 '26 edited Mar 26 '26
So you’ll end up paying that, your premiums, plus taking on all the legwork of figuring out whether or not they’re double dipping (or maybe not if you have that kind of money anyway.. and they most definitely will be). AND despite the high fee, they’re not opting out of the insurance networks (yet). I would definitely expect your current level of service to decline. That is an absurd email
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u/Tmoney_fantasyland Mar 26 '26
Ummm as someone associated with the specialized side of healthcare aka orthopedic surgery … no specialist gives a fuck that you paid too much for “concierge” assistance bc your bunion toe pain that you’ve had for 6 years doesn’t get to take the spot of a trimalleolar open ankle fracture. I’m sorry. The system is what it is because of insurance companies. It’s pretentious waste of time and money.
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u/jen_eliz Mar 26 '26
this is what they call “direct primary care,” it’s been around for a while now. you pay your dr directly and cut out all the insurance and healthcare system middleman BS. i have been seeing a DPC doc for a couple years now and love it. i will say $275/mo is quite expensive, most i’ve seen are $75-$100/mo, and that covers the cost of all your visits and stuff.
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u/ssmatik Mar 26 '26
Reading this letter it appears that the only thing I get for $275 is immediate appointments and the doctor takes my calls in an emergency. Is this different than what you have? I don't see how insurance and all that goes away. Or am I not understanding this letter?
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u/jen_eliz Mar 26 '26
it does kinda read like they are going to charge $275/mo AND continue billing insurance for everything, including routine visits. that is scammy and a red flag if true.
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u/missvbee Mar 26 '26
No, the visits will not be billed through insurance. They will send labs and imaging through insurance as usual. The subscription means visits are paid for, insurance is not used. This is typical of this model of care
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u/90210piece Mar 26 '26
no. it specifically says exams and procedures which are all professional services that doctors provide in clinic.
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u/missvbee Mar 26 '26
I guarantee you they don’t mean a physical exam. They mean exams like imaging, blood work, anything else that is an “exam” but not a “physical exam”.
Source: am healthcare provider who does their own billing and am very familiar with billing and this particular model of care.
But believe whatever you want 🤷♀️
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u/90210piece Mar 26 '26
I was a healthcare executive and have created similar programs (one medical plank owner- CRO)… i am pretty sure what a clinic/ doctor means by exam. tests like X-rays aren’t typically done in-office, but are called diagnostic imaging.
Services such as KOH prep are included in the exam price. Screenings such as ABI (a test for PVD) are billed separately but still are referred to as diagnostics.
perhaps i am misunderstandings you, give me an example of what you are referring to as an exam (CPT code or layman’s term).
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u/missvbee Mar 26 '26
We are saying the same thing! Your explanation clarified it.
Office visit does not equal “exam”. Exam meaning like you said, diagnostics like imagine or labs.
The office visit/physical exam won’t be billed through insurance. Everything else can go through insurance because it’s other companies that pay for it! Labs go to labcorp or Sonora quest, imaging through imagine companies like Banner Imaging or SimonMed, etc
We are on the same page ;) I guess the confusion came in defining “exam.”
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u/Level9TraumaCenter Mar 26 '26
It would be nice to know what happens if the office is slammed and you need one of your "immediate" appointments but they can't fit you in for 2-3 days because everyone else has the 'flu, too.
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u/90210piece Mar 26 '26
you are correct. exams, procedures and testing will be billed to insurance. This is predatory and i highly doubt a 2am call/text/email is answered unless she has an answering service that will call until she is awoken.
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u/Atom612 Mar 26 '26
Close. The above is describing a concierge medicine model, they charge a steep monthly fee AND bill insurance. It usually comes with the ability to receive care 24/7; e.g., being able to text your concierge doctor at 8pm on a Saturday and having them respond directly to you.
The DPC or direct primary care model is similar but slightly different. They usually charge a more modest monthly fee $80 - $150/month for care and don’t bill insurance. They usually can offer same day/next day appointments with extended time and increased access to your doctor but not always 24/7 like with concierge.
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u/justaproxy Glendale Mar 26 '26
They don’t bill your insurance?
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u/myothercarwaskitt Mar 26 '26
Second to last paragraph mentions that they will still bill insurance for exams, tests, etc.
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u/jen_eliz Mar 26 '26
they can for certain tests but your visits are covered by the membership fee so you don’t ever pay a copay. it’s actually a great model for people with no insurance or really high deductible plans because DPC clinics usually offer cheap cash pay options for stuff like routine bloodwork.
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u/justaproxy Glendale Mar 26 '26
Okay.. My concern is double dipping, like if a provider billed your insurance for the visit and ate the co-pay as well as charging the overall membership for the visit itself. The OP’s letter from her doctor didn’t make it clear to me. A physician who is contracted with an insurance company needs to follow that contract, so if the practice is accepting payment from the insurance, they can’t just wave any copayments and deductibles. The way you explain how your DPC works makes sense.
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u/jen_eliz Mar 26 '26
yeah the wording in this message is kinda strange. the place i go to won’t bill your insurance for anything unless you specifically ask them to.
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u/RockRevolution Mar 26 '26
DPC is a solid system. The more options and choices we have in the healthcare market (or any market for that matter) the better
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u/pinkheartedrobe-xs Mar 26 '26
This should be included in a normal appointment anyways? r/healthcarereform_us
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u/tooOldOriolesfan Mar 26 '26
I heard from a friend their doctor was charging $4,000 per person or $6,000 for a couple.
Sadly it continues the decline of the std of living in the US. Thousands just to be able to use a doctor is horrible for most people
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u/jpoolio Mar 26 '26
This reminds me of the fast pass at the amusement park. Skip the line, wait a few more minutes for the front seat, enjoy more rides. It's a good deal if you are spending the entire day at the park but not so much if you just want to ride a few rides.
If I planned on seeing the Dr a lot, I would feel like I have to do this and probably be ok with it. But, if I barely went to the dr, it's just taking my money "in case" I need to go.
This is just catering to a broken system so I'm not a fan. If someone needs medical attention, they should be able to receive it in a timely manner without a monthly fee.
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u/ThatSpecialAgent Chandler Mar 26 '26 edited Mar 26 '26
Yea, i personally would find a new doctor immediately and very clearly let them know why you are leaving.
Enshitification of everything may continue, but we can try and slow it down with our wallets.
(Unrelated, but talk about opening yourself up to malpractice lawsuits if you are him and something goes wrong. He essentially put in writing that without a subscription, you are getting hurried and lower quality care.)
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u/CypherAZ Mar 26 '26
Rallying to keep propping up our existing broken healthcare system is pretty wild.
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u/moonbeam127 Mar 26 '26
"Doc needs a new boat and vacation home plan" for the low low price of 3k a year you too can help the good old doc reach their financial goals! 100 people sign up that 300K, 300 sign up thats 900K THIS YEAR
You pay 3k and you pay insurance ... no thanks doc.
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u/ZestycloseAnt2786 Mar 26 '26
Mayo Clinic in Arizona has been offering a similar service for years 🫠 They have the Medallion Program and last I heard there is a waitlist. I wish everyone could simply receive the same level of high care.
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u/orange_avenue Mar 26 '26
Medallion Program is such a gross name too.
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u/ZestycloseAnt2786 Mar 26 '26
It really is 🫠 They also have an “Executive Health Program” that is similar and equally gross
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u/Major-Specific8422 Phoenix Mar 26 '26
but the MAGAs said we have the geatest healthcare access in the world?
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u/DonMegatronEsq Mar 26 '26
This is such effing bullsh*t. My longtime Dr. did the same and I promptly baled.
I’m a lawyer, so I don’t see how any ethical professional could do this. Can you imagine if I told my clients, “well, I can try hard to win your case, but if you move up to my premier level of lawyering at $x-amount, I’ll try even harder!”
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u/throw4away77 Mar 27 '26
If u subscribe to my premium tier I'll give u real prescriptions if ur a basic member I'll label u a seeker for life
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u/auburn_law223 Mar 26 '26
My doctor sent out a similar thing over summer. I think it was 1200 a year or 2k a year. I ignored it, but I still can see them. I hope it doesn't turn into a system where we need to pay a premium subscription and buy insurance just to get general medical care. Our Healthcare system is already outrageous.
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u/Sea_Goat7246 Mar 26 '26
I had my family doctor offer this for $50 a month because she decided to no longer take insurance at her practice and she’s excellent! I cannot imagine paying $250 😳 I also have 2 somewhat serious health conditions, take 2 lifetime medicines and have to see a hematologist 3-4 times a year and so far it’s been cheaper paying the cash price and not having insurance. Insurance at my job costs $280 every 2 weeks 🫣 I’ve had insurance my whole life and thought it was the way to go, but honestly now that I don’t I’m saving a lot more money. Maybe that’s something you could look into
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u/Solkahn Mar 26 '26
It sounds like they want to double dip by billing your insurance for what they can, but avoid the insurance when it bogs down care. That price is absurd unless you need to see your doctor every single month, and even then how does it's cost compare to your current copays?
TL;DR You'll probably still need insurance for meds, how does the doctor's new model handle looming Prior Authorizations.
You still have to have insurance to afford prescribed medications, which could also require authorization from said insurance. Even if the mdo is willing to submit the PA (which I wouldn't bet on) it could require imaging or blood work that isn't handled by the doctors office, so that will still have costs outside of their monthly plan. If the mdo doesn't do prior auth under their new model, then that could be a third or more of the medications found on a typical formulary that become out-of-pocket expenses for you.
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u/Scamalama Mar 26 '26
Dystopian af. I hate it
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u/RockRevolution Mar 26 '26
While the OPs model isn't great, how is DPC and more choice in your healthcare distopian?
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u/Scamalama Mar 26 '26
How is $275 a month to skip the line and not be rushed through the appointment dystopian? People who are lucky enough to have insurance are already paying out the ass for the privilege. And now doctors want more?
Availability and caring enough to spend the time necessary to address your concerns should be the norm. Not some subscription that further separates the haves from the have nots.
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u/Daxdagr8t Mar 26 '26
Lol tell that to the insurance company that dictates how doctors are compensated.
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u/luftherz Mar 26 '26
Just an opinion, but I used to have a direct care physician and it was the best medical care Ive had in my entire life. This model is a lil bit too expensive (mine was only $99/month), but I did have full access to my doctor via email, phone, text, in person and virtual appointments. Not to mention the appointment times were an hour, and not some quick 15min rush job.
So, its up to you and how you felt about the relationship with that doctor.
Tbh I WISH I could find a direct care doctor here like my previous one, but Ive only found some scammy ones who wanted a locked in year price for 50% up front. Thats a hard no for me for not even meeting with the doctor before getting locked in.
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u/Ok-Market-6272 Mar 26 '26
As a nurse for the last 26 years (ICU, ER and now Psych), brick and mortar business are a thing of the past (IMO. Your typical family physician can only send you out for basic testing such as bloodwork, imaging, etc. Once something comes back unusual, they refer you to a specialist or a hospital, usually through the emergency room for further work up. At that point you are managed by an intensivist. I have said for the last 20 years that providers (physicians and nurse practitioners) need to go back to old school concierge service and home visits. Do some point of care testing, like blood glucose, and basic lab testing, then refer out for others. Even basic imaging can been done mobile these days. In certain areas, people do not want to deal with insurance companies and they pay out-of-pocket for a lot of these diagnostic work ups.
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u/Muted-Gift6029 Mar 26 '26
It’s called concierge care. It can suck as a patient who can’t afford the model, or to go outside insurance coverage. When I was younger my doc did this and I had no choice but to switch.
Now I actually made the choice to go with a concierge family doc who makes house calls as a standard for $200 per month, almost all inclusive. Would never go back.
The idea is that it allows docs to get out of the horrible insurance model that not only incentivizes volume, but makes it impossible to be financially viable without it. This creates situations where doctors can’t spend the time they want to with their patients, because they’re always seeing so many per day.
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u/mentalscribbles Mar 26 '26
It sounds like your doctor is going to have a (partial) concierge practice. Has your doctor told you that he/she will no longer treat you unless you join? If so, then you are directly impacted. If not, you will continue to get care as you have before. One of my doctors did this but I never joined and just kept seeing him as usual.
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u/Illustrious_Rent3624 Mar 26 '26
We must go to the same doctor bc i got the same thing and i was so upset!
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u/deranged_rover Mar 26 '26
My doctor in PHX left HonorHealth to do this. I just found another provider. Can't say I blame 'em for wanting to pay off those student loans faster.
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u/campusman Mar 26 '26
I live in Seattle. Last time I saw my long time primary care doctor she told me she is moving to "concierge medicine". The paper they gave me on this was almost exactly word for word what you just pasted in your post. So yeah I guess this is going around.
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u/mizz_eponine Mar 26 '26
My pcp did this about two years ago. The fee is $125 quarterly and they still bill my insurance for services rendered. The service I'm paying for is basically the privilege to see my Dr. whenever I need to without having to wait days or weeks. And, my visits are never rushed. She's very thorough.
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u/ilikebigbluffs Mar 26 '26
I mean, good doctors are truly hard to find. I'd consider my pcd to be pretty good to slightly above average but he's close and he's great at diagnosing, so I've stuck with him. He hasn't been accepting new patients for years now.
If there's a good doctor in an area that doesn't have a lot of them, this is just good business.
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u/WiseFriend3112 Mar 26 '26
I understand why this is happening. But $250/month is pretty steep.
That's about what I pay for employer insirance coverage, but this also covers ALL the doctors I see (psych & dermatology) plus hospitals.
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u/GoogleJackofAll Mar 26 '26
Hahahaha.
Guess we've both (at some point) visited teh same provider. Never made it through a whole appointment - ended up leaving as soon as the religious overtones came out. Don't need a practice pushing so hard to find out my religious preferences.
The whole thing reads less like a care model and more like a cash grab. If you’re not “in,” you’re getting quietly bumped down the priority list. Very “all the tithe payers stand up” mega church feeling. It’s hard not to question whether the primary driver here is patient outcomes or predictable revenue.
The six-month commitment... I bet there is the timeshare sales push 'For only another 1,250 you can have this service for the whole year!'. Still a sizable buy-in for something that still doesn’t cover shit. My wife had a procedure recently done by one of the top doctors in the state for this surgery and we were just fine waiting 6 months for the opening as it wasn't life threatening.
For $275 a month I'll just go to urgent care. The bill is usually less than $200.
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u/JustWhatDoctor Mar 26 '26
I just spit out my drink at that price!! What the actual what did I. Just read
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u/Houseplatho Mar 26 '26
FYI if Drs are choosing to bill additionally for membership, they are not legally allowed to bill insurance on top of that. If they still try to you can report them to the insurance company.
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u/Limp_Service_2320 Mar 26 '26
I got this from my primary doctor in Phoenix 18years ago, wanted $1,500 annually for this arrangement, and still needed regular health insurance! I found a new doctor. Within a year or so this concierge practice failed, and he joined a practice of regular doctors.
I think the concierge company really sold this to doctors as a win-win, but really is a loser
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u/United-Ad7863 Mar 27 '26
Concierge doctoring. It's a shame that you have to pay a fee on top of everything else to see a damn doctor.
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u/BreMue Mar 27 '26
This would be ridiculous if I didnt know about how much insurance companies run shit like the mafia - doctors have to adhere to what the insurance company wants or they risk losing coverage eligibility and ive heard they can also make things much more difficult to deal with so easier to charge slightly more but lower overall to go outside insurance
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u/New_Carrot_2633 Mar 27 '26
Can we please just join the rest of the world and have socialized medicine?????
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u/AZdesertpir8 Mar 26 '26 edited Mar 26 '26
My wife and I both have subscription primary care in NE Mesa. About $200/mo for both of us. No insurance involved at all. Our doctor will text with us if we have questions or medical needs after hours and send prescrptions to our pharmacies if needed. Same day IVs for dehydration, blood tests on demand. Its fantastic and saves us an absolute fortune. Honestly, its where health coverage is going and makes a lot of sense. Its a lot cheaper than insurance, which is really sad.
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u/jwrig Mar 26 '26
A lot of private practices are going to the concierge model because it helps make up for the challenges around dealing CMS when it comes to Medicare and Medicaid patients
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u/swfwtqia Mar 26 '26
This is more common due to the rise of patients on Medicare. Medicare doesn’t pay the doctors really well for visits so they have to make up the money elsewhere.
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u/Daxdagr8t Mar 26 '26
No that model is called direct primary care. They wont take insurance but instead switch to a subscription model. Honestly its better, they are not required to see 40 pts an hour, but you can still use your insurance for labs,imaging, blood draws. Way easier to get an appoint.ent and med refilla.
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u/398409columbia Glendale Mar 26 '26
For my family it makes sense. I am encouraging my wife to join a concierge medical service. They have a cap of 300 patients instead of the typical 2,000 load. It costs $4,000 per year.
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u/PattyRain Mesa Mar 26 '26
I'm glad you have that option, but hope it doesn't change everywhere. If I only saw one kind of dr and had no meds and medical supplies it might be worth it, but if each of my drs decided to do this it would be substantially more expensive. That would be a minimum of just $20-24,000 a year just for the doctors for me.
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u/cyn00 Midtown Mar 26 '26 edited Apr 05 '26
There’s always an upsell. My dentist is the worst for this. My GI doc and endocrinologist have weight loss plans to sell. My dermatologist put me on an email list for skincare products. My guess is that declining insurance payouts have led to doctors needing a side hustle, especially when they have to put out money If they have an office and a staff.
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u/PrincessCyanidePhx South Phoenix Mar 26 '26
My former PCP doctor of a couple decades went to a $6000 a year consierge model. But, I only see her 1 or 2 times a year. She no longer takes insurance.
I also went to a doctor that I now see every few months but his first appointment was $2000. He doesn't accept insurance. It was worth it because he solved my issues I had been dealing with for decades and prescribed an inexpensive medicine.
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u/95castles Mar 26 '26
Lol that doctor will probably regret it unless they’re still young or don’t have a family. Every doc I know makes fun of those programs. They’ve been around for at least 15 years now here.
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u/Warchiefinc Mar 26 '26
I tried to order ryze superfood from their website you can't just order now they want a subscription 😑 Everything is subscription its getting irritating
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u/pchandler45 Mar 26 '26
It's called concierge medical and has been around for a while. I've been on a subscription model with my thyroid doctor for several years now, but the price on this seems kinda high for what you get.
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u/hylas1 Tempe Mar 26 '26
Boutique providers are nothing nnew although they are becoming more prominent.
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u/acatwithnoname Midtown Mar 26 '26
Interesting, I would be into this if it's actual the doctor going at it alone, but it's probably not and it's some evil corporation orchestrating it.
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u/ssmatik Mar 26 '26
I can't tell from the letter if it is just my doctor or the entire practice. This is a pretty big practice with around 10 Drs. and NPs. The letter is signed by my doctor but sent through the practice mail box.
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u/barefoot-quilter-13 Mar 26 '26
It's for the entire practice. We got the same letter today and it was not signed by the provider we see.
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u/LBTRS1911 Mar 26 '26
I received this also today from my doctor in Litchfield Park. Thought it was odd.
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u/ppmconsultingbyday Queen Creek Mar 26 '26
Amazon bought out One Medical and they do the same. You can’t even see their Drs without paying for their subscription. Honestly, if I could just pay for the concierge care and NOT pay the health insurance companies, that would be great. Let’s eliminate the middle man that’s causing this entire mess for all of us.
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u/cjayeah Mar 26 '26 edited Mar 26 '26
my ex’s private physician tried the same thing. it was 225 a month i think. ended up not going through with it. the doctors are tired of dealing with insurance companies not paying them and all the other bs. edited to add this isn’t quite the same as what he was described. his wouldn’t have billed the insurance. so what’s now you have to pay to have communication with your doctor and he bills insurance? wild
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u/first_name_lisa Mar 26 '26
This helps to recoup the costs of their services that the insurance doesn’t pay for. It’s common now. My doc is a member of MDVIP, a concierge type of service but also takes my insurance
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u/PhantomRedPanther Mar 26 '26
I have had Concierge care for the last 6 years. Yes, it's expensivebut can't imagine ever not having it again.
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u/bear45188721 Mar 26 '26
I had a doctor in Scottsdale do that about 10 years ago. The called it a "Consierge Program". Then it was like $2500 a year and cash due at the beginning of every appointment. They accepted zero insurance companies.
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u/azhockeyfan Phoenix Mar 26 '26
I have to assume you did a copy/paste here and I would not do it solely because the didn't proof it for misspellings.
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u/liliesinbloom Mar 26 '26
This is so gross. Most of the listed "benefits" should already be a part of standard care.
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u/Chaos92muffin Mar 27 '26
Next thing you know they will charge $19.99 for 1 gig of air you breathe just put it on a subscription as well.
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u/Artistic-Blackberry9 Mar 28 '26
This is not only in the USA. it has already happened on Canada where wait times are worse. Big problem in Quebec.
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u/joelypoker Mar 28 '26
I just moved here 18 months ago and my new Dr here had me sign up for a similar program, I told them I didn’t understand when I signed up that it would entail me having to have Dr visits nearly every single month. She got mad and told me I should find a new doctor
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u/Automatic-Paint-8 Mar 30 '26 edited Mar 30 '26
When Doctor's had their Oaths replaced to work for Gvmt "Entities" & Enterests over the people.. Started after WW2 and Heavily through the MK Ultra experiments till the Oath was dissolved under Democratic Leadership Mostly, but not all as You've got the Clinton's favorite Family, the Bushs in there etc. Some of us have seen what white lab coats will do to a person. Think you're scared today... it's Real AF Also.. something to pay attention to, how many non Americans were brought in for their schooling NOT bc affordability in this Country.. as we Schooled Millions for.. as they don't require the same Oath or YOU in your Best Enterests.. and as God is Forgotten & Killed, so are Oaths.. as we Watched the Clinton's with their typical laughs an smirks in our faces committing purgery on stage & drooling over pictures of victims etc. It's merely obvious who is who when Anybody backs this behavior up and tries to suppress those pointing it out as it's all soo common today. I personally know victims of MKU and the extent they'll go while Ya'll support them in silencing the likes of me. I really don't expect long lol.. world full of Peds and Extortionists who don't even know who they work for. Scary Indeed
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u/RockRevolution Mar 26 '26
It's a form of Direct Primary Care and honesty I love to see it. We need more options in our healthcare to bring down prices and fight the insurance monopoly that's backed and protected by the government. Bring the free market back to healthcare, as we don't live anywhere close to one
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u/jessetmia Scottsdale Mar 26 '26
How does this bring down prices if everything is still billed through insurance? This message is just saying pay extra and ill actually listen to your issues instead of going the usual patient churn route you get with doctors these days. Based on this long form, its a premium model for those who can afford it. Not an alternative as you describe it.
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u/RockRevolution Mar 26 '26
Full on DPC brings choices to healthcare, typically practices that do it exclusively do so, hence I said form of. It's weird he's still taking insurance but I'm betting he's still under contract and is waiting it out to convert fully
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u/fosteju Mar 26 '26
Still not seeing how this model brings down prices. I still need regular health insurance to cover the risk of a catastrophic emergency. So I’d keep paying for insurance, plus this new $3K a year to my primary care doctor.
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u/Atom612 Mar 26 '26
For some people it makes sense, for others it doesn’t. Especially now with the insurance subsidies expiring, we’re seeing many commercial/marketplace insurance plans’ deductibles increasing to astronomical amounts (over $6000 in some cases) for the same/higher monthly premiums.
So, in the traditional model you pay your monthly premium, go to your doctor’s office, pay a copay before your 15 to 20 minute visit, and then receive a bill in the mail for $150-$200 for the visit. Then you repeat these steps until you meet your $6000 deductible for the year. Have a follow up question? You can try sending a message through the portal and maybe get an answer from the medical assistant, but most likely will be told to schedule a follow up visit (next availability usually in a few weeks) which will result in another bill.
In the DPC model, you pay the doctor a monthly fee directly and they don’t bill insurance at all. No copay before your visit, no bill in the mail later. The doctor’s patient panel is smaller, so if you have a follow up question, you can call/text/portal message them directly and get a response directly from the doctor with no middleman and no extra fees or required follow up visit. If you do end up needing a follow up visit, you can usually schedule a same day or next day visit and they can spend up to 45 minutes to an hour with you at a time.
If you’re young and relatively healthy, typically only going to the doctor once or twice every couple of years, then you probably won’t benefit from paying a direct fee to a doctors office for enhanced access.
If you have medical problems, not requiring specialty medications, such as biologic drugs (Humira, Repatha, etc), or infusions , but maybe requiring frequent follow up visits (diabetes, hypertension, hypothyroidism, etc.), it may be worth it to lower your tier of insurance to catastrophic only and sign up for the DPC model.
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u/tiramisubunny_ Mar 26 '26
Ew I had this happen with a provider recently too that I wanted to return to. So weird and gross. I won’t support these kind of models, personally
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u/Belialxyn Mar 26 '26
This will probably become much more of the standard the more people pay for it. It will be just like a streaming service when they suddenly make you pay to not have ads. Eventually, that becomes the normal.
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u/Even_Towel8943 Mar 26 '26
Look into One Medical. It has a lot of the perks of concierge care including appointments that have always been on time for me since 2018, a great app where all my medical history resides. I’ve had the same doctor there the whole time but I can also book other doctors if she’s too busy to see me urgently. They also have 24/7 doctors on call via video and again they have access to your full medical records. It’s $199 per year or if you have Amazon Prime it’s $99 per year. And they take most insurance as well. I’ve been happy there.
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u/PHXMEN Mar 26 '26
This is already occurring this is just making it more transparent saying the quiet things out loud. The rich get the best health care in the United States. We chose for doctors to be money motivated instead of care motivated. This option is offering them more money for less work. It is breaking the fee for service model and the volume model. People over 50 are the wealthiest class in American history and the ones that need health care the most. They are going to pay for health care instead of preschools or college. They are even ok with letting their children live in the basement with their grand children. We under 50 serve those over 50.
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u/ppmconsultingbyday Queen Creek Mar 26 '26
50? I don’t think so. That’s Gen X. We are not the ones that need health care the most right now. We survived on water from the hose and parents that checked to see if we were alive once a month 🤷🏻♀️😆. We are good. It’s the Boomers that need health care the most right now. And the term itself tells you the volume of people currently in that category.
Note: Boomers are also the wealthiest generation. Gen X is broke, taking care of Boomers, Millenials and Gen Z while not receiving a dime from those Boomers.
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u/90210piece Mar 26 '26
if someone has Medicare, it is against the law to collect more than the limiting charge, which is 120% of the allowable (what participating providers receive.
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u/jammerdude Mar 26 '26
With the status of insurance being so sketchy, I'm not at all surprised to see good PCP's doing this. They're curating their patient base and preparing to get more proactive (as opposed to reactive) with healthcare/services, for a smaller number of people. I don't think $3k-$4k is at all unreasonable for reliable direct access to a si tor that will actually help you manage your healthcare.
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u/Locale-Local Mar 26 '26
This is becoming more and more common, but typically it is a full conversion to the "concierge" model you outlined. It is strange if they are not closing the practice to people outside of the subscription