[lmm]

> I pay $50/mo for a single provider, unlimited visits / communication, and highly discounted labs. She makes house calls on occasion. This doctor is working solely in my interest, and has little concern of insurance, except to help me navigate that system should I need a specialist, prior authorization, etc.

Someone's presumably paying her more than $50/hr, which will burn through your monthly fees pretty quickly. Where's the money coming from?

[genocidicbunny]

It works the same way that health insurance works -- most people don't need all that much care, and when time-consuming care is needed, it is often pushed to the specialists rather than the generalist. Your $50/mo payment might not seem like much, but if all you're doing is a bi-monthly checkin with them over the phone, you're really paying more like $100/visit for a 15-30 minute visit.

A lot of these 'concierge medicine' services are set up to deal with mostly people who don't need all that much medical care, beyond relatively brisk access to the doctor in a few rare circumstances. Since they also don't really do much in terms of specialty care, they tend to have fewer Px who need extensive personal care.

[onlyrealcuzzo]

Doctors make $20k a month or more.

That's 420+ patients at $50/m.

Doesn't seem feasible to know them all personally and deeply.

Other revenue would be needed.

[recursivecaveat]

It is totally feasible and not uncommon for a family doctor to have 2000+ patients. Young healthy people can go years without interacting with the medical system, and when they do it's often some thing that barely involves their doc. I mean their doc doesn't know them personally then, but they have no problems worth surfacing clearly so why do they need to? The limiting factor really is the quantity of seniors and people with complex chronic conditions that you take on.

[genocidicbunny]

You're not going to be seeing every patient every month. Many you might only be seeing a few times a year; They will have a quick phone chat every few months to make sure their prescriptions are up to date, maybe order a blood panel or two to stay on top of things. They're not coming in every week for an hour-long deeply-personalized appointment. As long as the practice limits itself to a reasonable number of patients, they should be plenty solvent.

We're talking about basic preventative care here. Your doctor doesn't need and probably doesn't want to be your friend for these sorts of things. There doesn't need to be a deep personal relationship there if it's not necessary.

(But also, $50/mo is a very low price. I've seen plenty of such services that are in the $500+/mo range. It's still way cheaper than health insurance would cost out of pocket, but it's not 'cheap' either.)

[in_cahoots]

420 young, healthy patients probably see the doctor 2x a year at most. That's less than 20 visits a week for the doctor. And as soon as you become unhealthy you are passed along to a specialist or dropped.

You're paying for the bedside manner, not the medicine.

[sshine]

I’m 39 and I see my doctor once a year, at most. This year I had a urinary thing. Last year and the year before that I had a rash. The year before that I didn’t go. For all of my twenties I went three times. She still remembers me just fine, asking how is my CrossFit doing.

I see my wife’s doctor more often than my own because he is also our newborn son’s doctor.

They both have thousands of patients. The waiting rooms mostly have elderly, parents with their newborns and obese people.

[potato3732842]

>She still remembers me just fine, asking how is my CrossFit doing.

That's because just before she walks in she reads your chart.

[sshine]

My chart doesn’t mention my hobbies. But yes, she does read my chart. It’s not very interesting.

[collingreen]

Which seems plenty good enough for the care op wants

[zetazzed]

In the models I've seen, they still require and bill insurance. The monthly fee is a supplement for the doc practices.

[fluidcruft]

You're also probably fairly healthy and not much work. Concierge care for my elderly parents with complex diseases has been quoted at $20k/year.