My undiagnosed pain problem seems to be coming back - either that, or I've had a broken toe for the past 3 months which sometimes makes the rest of my foot (and sometimes my elbow) hurt, too. I could go back for PRP therapy, but I thought I'd try again for an actual diagnosis. That means that I'll have to collect my medical records from about 7 places and find someone who will actually read them and use his mind to try to solve the problem. Regular doctors have no time to use their minds. (Hey, that's a bit like parenting!)
Thanks to a suggestion from Paul Hsieh on a private list, I found out about something promising: concierge medicine. I knew there were doctors out there who don't take insurance, but I had assumed that they were unaffordable. Those doctors may exist, but concierge medicine is something different. The doctors still take your insurance, but you also pay a yearly fee for extra service. The doctors only take a maximum of about 600 patients, instead of thousands. The fees vary, but the ones I'm looking at charge $1,500/year. That's only $125/month. I can afford that!
There is a national group called MDVIP which has standardized the cost and service levels for the member physicians. I'm sure there are plenty of independent operators out there, too, but what you get with MDVIP is:
- 24X7 access to your doctor
- a real annual physical exam which covers much more than your insurance would
- same day or next day appointments - for anything
- appointments that last as long as necessary
- a CD containing your medical records
- assistance with insurance issues
- a doctor who might even come with you to a specialist appointment or surgery
You also get a doctor who has chosen to practice real medicine instead of herding sheep through his office. This is the biggest selling point to me. These doctors want to use their minds!
There is another organization called the American Academy of Private Physicians from which I'm drawing referrals as well, but I'm not sure of the annual fees yet with those. I'm going to interview at least 3 doctors and give this a shot. Here are the questions I've come up with to ask each doctor. If anyone has any suggestions for other questions, I'd love to hear them.
- How many doctors in your practice and do they all participate in concierge medicine?
- How many patients in your practice? How long are appointments?
- Why did you decide to practice concierge medicine and how long have you been doing it? Has it lived up to your expectations? How could it be even better?
- What is your philosophy of care, if any?
- How do you decide on specialist referrals? Will you coordinate my care? Will you help me get appointments?
- What are your views on nutrition and exercise?
- I believe in informing myself about health issues and being an active part of my own care. What if I come in with information on a study I found on the Internet or from a book and ask you if it is valid? If you’ve never heard of the study, will you take the time to research it and help me understand if it is scientifically valid?
- What does “evidenced-based medicine” mean and what is your view of it?
- What tools do you use for diagnosis? Is trial-and-error with medication part of diagnosis?