A few months ago, I heard about this new service that some doctors are offering. I’ve got mixed feelings about it, but here’s the basic breakdown: both doctors and patients are fed up with the current way of handling health care. Insurance companies will only pay a certain fee for the doctor’s services, and out of that fee, the doctor must take care of his staff, his practice, his malpractice insurance, and his own salary. [And, I’m using the gender-neutral “he” because 1) I was taught that in school and habits are hard to break; and 2) this is a birth blog, and all people who give birth are female, while not all doctors are, so this helps to cut down the confusion.] Because of these financial restraints on the doctor’s part, he feels coerced into accepting as many patients as possible — and probably more patients than he can reasonably see in a day. How many of us have not felt short-changed by the amount of time a doctor actually spends with us (especially in contrast with how long we had to sit in the waiting room).
So, concierge service was born. Basically, you pay for exclusive service. The doctor agrees to limit the number of patients he sees, and you agree to pay a certain fee over and above your usual payments and copays for this “VIP treatment.” The part I don’t like about it is, shouldn’t you be getting good service anyway?? Why do you have to pay extra for the minimum? The part I like about it is, it works! And it works beautifully (as long as you can afford it) — some perks that medical “concierge service” offers include that the doctor actually knows you, not just your file; you can be seen within a day or two whenever you need to come in; and your doctor can actually spend time with you, finding out about your needs and complaints and special circumstances, so that you don’t feel like you’re a widget on an assembly line; plus access to the doctor’s email and/or phone numbers.
But now, I’ve read an article which says that some obstetricians are now offering “concierge service.” [This is the complete opposite from another new-fangled solution for the problem of over-worked obstetricians — laborists.] For the low price of $15,000, pregnant women get the following from Dr. Lanalee Sam: “a fetal ultrasound photo at every visit, private birthing classes, one massage per trimester, optional home doctor visits, her private home and cell phone numbers and e-mail address, and the guarantee that she will be at the hospital for her patients’ full active labor and delivery.” (This service, as I mentioned above, is in addition to the regular fees the doctor charges.) Since so many doctors are in a group practice, it’s entirely likely that a woman can have a complete stranger attend the birth of her baby, unless she met every one of the doctors during prenatal visits. So the guarantee of your obstetrician definitely being with you for your entire labor and birth is not inconsequential. This doctor does this by accepting women based on their due dates — no more than 4 per month.
All right — I can’t help it — I’ve got to run the numbers. Four women per month, twelve months per year, and $15,000 apiece — that works out to (drum roll, please) $720,000. (Plus what she makes from her regular obstetric fees, and her gynecological practice.) I know that malpractice insurance is high for obstetricians — but is it that high? — especially attending only 48 births per year, instead of 48 births per week or per month. Although, to be fair, I will reiterate that there are other costs involved in being a doctor — the overhead of the building — rent, electricity, equipment; receptionist, nurses and other staff; and everything else down to paper clips and staplers. Also, she sometimes discounts her fee, or waives it entirely. I’m not meaning to “pick on” this doctor, but she was the only OB mentioned in this article — so I’m just using her as an example.
So, reading about this, I gotta say, “Now this is the way to go!” I mean, look at the perks — you get long prenatal visits (instead of seeing the doctor 5 minutes, 15 if you’re lucky), you feel free to call or email the doctor any time something comes up that concerns or worries you (and you actually get to talk to the doctor, and not just wait around for a day or a week for somebody in the office to finally call you back), and the doctor may even come to your home, instead of you always leaving yours. That sounds great! Oh, wait a second — I did have that! It’s called midwifery care (and I didn’t have to pay $15,000 for the privilege). Now that’s the way to go!
Filed under: labor and birth Tagged: | baby, childbirth, concierge service, gynecologists, health, labor and birth, laborists, midwife, midwifery, midwives, ob, ob-gyn, obstetricians, pregnancy, pregnant