RE: non covered benefits (revisited)

[Guest guest]

I think we are talking 2 different extended services hereAs primary care  physicians I agree we have to provide emergency availability ...but the key is emergency..

the availability that is being provided as ncbf is round the clock  nonemergency convenience access

 

I agree about taking our call and being available and that it is easier to cover yourself than be in large call group, etc. However, how come specialists are not held to the same standards? Our local cardiologist puts on his machine to contact your primary doctor after hours if you need anything. A local psychiatrist cancelled my patient's appointment and when she called to get a refill of her medicine, the message said to go to ER if you need medications. When she went to the office for the follow up appointment, there was a note on the door saying there was a family emergency and if you need medications, go to the ER. They did not even try to call her to cancel the appointment. Last summer I got a call and when I answered it, it was a local HMO I participate with testing to see how long it took for me to call back.

Just my two cents!

Margaret

Re: " non covered " benefits (revisited)

>

>

>

>Ok

>

>

>I have been feeling very stupid making patients come in for stuff that I could

>do without requiring a reimburseable visit. However I also do not want to give

>my services away.

>

>

>Would a subscription only electronic triage service make sense?Patients check in

>and answer questions, Physicians reviews the info and determines if they need to

>come in or it can be done without a visit. and triages to office visit, or does

>whatever is necessary.

>

>

> Patients can be provided services that would not be web

>visits/ telephone consults. You could argue this is all semantics, but some

>names get you in trouble, some names get you paid!

>

>

>It provides

>- value to the patient saves time and money for the patient who wants it.

-- Sangeetha Murthy M.D7830 mont Mesa Blvd #287San Diego, CA 92111www.mypcponline.com

[Guest guest]

I think we are talking 2 different extended services hereAs primary care  physicians I agree we have to provide emergency availability ...but the key is emergency..

the availability that is being provided as ncbf is round the clock  nonemergency convenience access

 

I agree about taking our call and being available and that it is easier to cover yourself than be in large call group, etc. However, how come specialists are not held to the same standards? Our local cardiologist puts on his machine to contact your primary doctor after hours if you need anything. A local psychiatrist cancelled my patient's appointment and when she called to get a refill of her medicine, the message said to go to ER if you need medications. When she went to the office for the follow up appointment, there was a note on the door saying there was a family emergency and if you need medications, go to the ER. They did not even try to call her to cancel the appointment. Last summer I got a call and when I answered it, it was a local HMO I participate with testing to see how long it took for me to call back.

Just my two cents!

Margaret

Re: " non covered " benefits (revisited)

>

>

>

>Ok

>

>

>I have been feeling very stupid making patients come in for stuff that I could

>do without requiring a reimburseable visit. However I also do not want to give

>my services away.

>

>

>Would a subscription only electronic triage service make sense?Patients check in

>and answer questions, Physicians reviews the info and determines if they need to

>come in or it can be done without a visit. and triages to office visit, or does

>whatever is necessary.

>

>

> Patients can be provided services that would not be web

>visits/ telephone consults. You could argue this is all semantics, but some

>names get you in trouble, some names get you paid!

>

>

>It provides

>- value to the patient saves time and money for the patient who wants it.

-- Sangeetha Murthy M.D7830 mont Mesa Blvd #287San Diego, CA 92111www.mypcponline.com

[Guest guest]

Gotcha. We don’t provide “nonemergency

convenience access” We have lives, too!

Pratt

Office Manager

Oak Tree Internal Medicine P.C

www.prattmd.info

From: [mailto: ] On Behalf Of Sangeetha Murthy

Sent: Thursday, January 20, 2011

11:59 AM

To:

Subject: Re:

" non covered " benefits (revisited)

I think

we are talking 2 different extended services here

As primary care physicians I agree we have to provide emergency

availability ...

but the key is emergency..

the availability that is

being provided as ncbf is round the clock nonemergency convenience access

I agree about taking our call and being available and

that it is easier to cover yourself than be in large call group, etc. However,

how come specialists are not held to the same standards? Our local cardiologist

puts on his machine to contact your primary doctor after hours if you need

anything. A local psychiatrist cancelled my patient's appointment and when she

called to get a refill of her medicine, the message said to go to ER if you

need medications. When she went to the office for the follow up appointment,

there was a note on the door saying there was a family emergency and if you

need medications, go to the ER. They did not even try to call her to cancel the

appointment. Last summer I got a call and when I answered it, it was a local

HMO I participate with testing to see how long it took for me to call back.

Just my two cents!

Margaret

Re: " non covered " benefits

(revisited)

>

>

>

>Ok

>

>

>I have been feeling very stupid making patients come in for stuff that I

could

>do without requiring a reimburseable visit. However I also do not want to

give

>my services away.

>

>

>Would a subscription only electronic triage service make sense?Patients

check in

>and answer questions, Physicians reviews the info and determines if they

need to

>come in or it can be done without a visit. and triages to office visit, or

does

>whatever is necessary.

>

>

> Patients can be provided services that would not be web

>visits/ telephone consults. You could argue this is all semantics, but some

>names get you in trouble, some names get you paid!

>

>

>It provides

>- value to the patient saves time and money for the patient who wants it.

--

Sangeetha Murthy M.D

7830 mont Mesa

Blvd #287

San Diego,

CA 92111

www.mypcponline.com

[Guest guest]

Gotcha. We don’t provide “nonemergency

convenience access” We have lives, too!

Pratt

Office Manager

Oak Tree Internal Medicine P.C

www.prattmd.info

From: [mailto: ] On Behalf Of Sangeetha Murthy

Sent: Thursday, January 20, 2011

11:59 AM

To:

Subject: Re:

" non covered " benefits (revisited)

I think

we are talking 2 different extended services here

As primary care physicians I agree we have to provide emergency

availability ...

but the key is emergency..

the availability that is

being provided as ncbf is round the clock nonemergency convenience access

I agree about taking our call and being available and

that it is easier to cover yourself than be in large call group, etc. However,

how come specialists are not held to the same standards? Our local cardiologist

puts on his machine to contact your primary doctor after hours if you need

anything. A local psychiatrist cancelled my patient's appointment and when she

called to get a refill of her medicine, the message said to go to ER if you

need medications. When she went to the office for the follow up appointment,

there was a note on the door saying there was a family emergency and if you

need medications, go to the ER. They did not even try to call her to cancel the

appointment. Last summer I got a call and when I answered it, it was a local

HMO I participate with testing to see how long it took for me to call back.

Just my two cents!

Margaret

Re: " non covered " benefits

(revisited)

>

>

>

>Ok

>

>

>I have been feeling very stupid making patients come in for stuff that I

could

>do without requiring a reimburseable visit. However I also do not want to

give

>my services away.

>

>

>Would a subscription only electronic triage service make sense?Patients

check in

>and answer questions, Physicians reviews the info and determines if they

need to

>come in or it can be done without a visit. and triages to office visit, or

does

>whatever is necessary.

>

>

> Patients can be provided services that would not be web

>visits/ telephone consults. You could argue this is all semantics, but some

>names get you in trouble, some names get you paid!

>

>

>It provides

>- value to the patient saves time and money for the patient who wants it.

--

Sangeetha Murthy M.D

7830 mont Mesa

Blvd #287

San Diego,

CA 92111

www.mypcponline.com

[Guest guest]

Yes, it is being available to questions and the urgencies and whatever the

patient is concerned about. I want patients to be calling way upstream of their

emergency.

I think of it as being paid a salary by my patients and when they do pay, the

barriers fall.

I do think it is legit to charge for 24 x 7 personal coverage.

Although I have to provide a system for patients to have access for emergencies,

there is a big difference between the call group and the 24x7 personal coverage

(that I know many of you provide without an extra fee as the cost of having a

practice).

I don't agree in the contracts that I personally will be available by phone or

that I will give all my patients my home phone. In fact when I told BC/BS what

the fee is for, the rep volunteered that this service was over and above what is

required or expected of providers.

Although it is easier to cover one's own patients, that doesn't decrease it's

value to the patient/consumer - must we always suffer before we ask for

compensation?

I do miss the days when I could have more than half a beer and when I could hike

or camp without checking on my cell signal first. 24 x 7 commitment is a big

deal - it is easier than covering 14 doctor's patients during those 60 hours of

weekend coverage, but it's not without its challenges and sacrifices. I feel

good about the $10/month - it's a steal and a win-win. I'll have some

conflicts if patients start opting out.

Stew

Re: " non covered " benefits (revisited)

I think we are talking 2 different extended services here

As primary care physicians I agree we have to provide emergency

availability ...

but the key is emergency..

the availability that is being provided as ncbf is round the clock

nonemergency convenience access

I agree about taking our call and being available and that it is easier to

cover yourself than be in large call group, etc. However, how come

specialists are not held to the same standards? Our local cardiologist puts

on his machine to contact your primary doctor after hours if you need

anything. A local psychiatrist cancelled my patient's appointment and when

she called to get a refill of her medicine, the message said to go to ER if

you need medications. When she went to the office for the follow up

appointment, there was a note on the door saying there was a family

emergency and if you need medications, go to the ER. They did not even try

to call her to cancel the appointment. Last summer I got a call and when I

answered it, it was a local HMO I participate with testing to see how long

it took for me to call back.

Just my two cents!

Margaret

Re: " non covered " benefits (revisited)

I don't like the " wink, wink " aspect either. I've struggled with that and

don't

have it totally figured out yet. I have not implemented this concept yet so

its

still a work in progress. Talking about it here is helpful, so thank you.

I do have a subscription website which I really enjoy doing, but it is what

I

describe as a coaching website for " healthy habits " (and weight loss but we

don't focus on that aspect). There is no significant one-on-one

communication

via this website.

In regard to the practice subscription website concept, I would love to

deliver

part of the primary care package this way. The health info/education is " my

take " on how my patients can be healthier. So it would be a lot like my

healthy

habits site in that regard but more directly interactive with the " virtual

communication " . How to frame it? Perhaps I would say that this is one method

that I offer, in addition to traditional office visits, to provide the best

possible care and information to the patients who are interested in

optimizing

their health. Most of my patients love the fact that I spend so much of

their

visit providing them information they can use to improve their health, the

subscription website would be a way to expand on that. Rather than saying I

only offer the web/phone visits through the site, I might explain that the

site

provides the mechanism to have an ongoing 'virtual conversation' between

myself

and the subscriber/patient. I could then choose to still offer traditional

virtual visits that are more limited in scope to non-subscribers as I have

been

doing currently (if I found it worthwhile to continue).

Here are some examples of what I consider 'ongoing conversations': I have

one

patient who loves to update me on every symptom she has on a regular basis

by

email. I counted a total of what could have possibly been 17 billed visits

over

a nine month period via emails (each possible visit being several emails

back

and forth per visit) - none of which I billed because I cannot say where one

visit begins or ends. Nor would she have tolerated being billed 17 times.

Others want me to tell them what screening labs to do through their

extensive

workplace screening program ... which means I have to review their chart to

see

what needs updating, what other labs offered (like 25(OH)D, B12, estradiol,

VAP

etc) might be appropriate for them. Then, they want me to phone them (or

email)

about their results for free. I prescribe a lot of hormones and some

patients

often need more hand-holding than others and want a more continuous

conversation. These are just a few examples of what could be done in that

'ongoing conversation' vs simply telling these folks to come in to the

office to

discuss these things.

These services could be delivered as part of a membership practice like

's, but I'm not allowed to do that in this state. Or, it could be

part

of Jean's dollar a day offer- but again, I cannot do that here. Overall, I

see

it as a hybrid version of a practice like 's- still taking insurance

for

office visits but providing the more continuous stream of care and

information

via the subscription.

To drone on a bit more in relation to the content that could be provided...

[Guest guest]

Yes, it is being available to questions and the urgencies and whatever the

patient is concerned about. I want patients to be calling way upstream of their

emergency.

I think of it as being paid a salary by my patients and when they do pay, the

barriers fall.

I do think it is legit to charge for 24 x 7 personal coverage.

Although I have to provide a system for patients to have access for emergencies,

there is a big difference between the call group and the 24x7 personal coverage

(that I know many of you provide without an extra fee as the cost of having a

practice).

I don't agree in the contracts that I personally will be available by phone or

that I will give all my patients my home phone. In fact when I told BC/BS what

the fee is for, the rep volunteered that this service was over and above what is

required or expected of providers.

Although it is easier to cover one's own patients, that doesn't decrease it's

value to the patient/consumer - must we always suffer before we ask for

compensation?

I do miss the days when I could have more than half a beer and when I could hike

or camp without checking on my cell signal first. 24 x 7 commitment is a big

deal - it is easier than covering 14 doctor's patients during those 60 hours of

weekend coverage, but it's not without its challenges and sacrifices. I feel

good about the $10/month - it's a steal and a win-win. I'll have some

conflicts if patients start opting out.

Stew

Re: " non covered " benefits (revisited)

I think we are talking 2 different extended services here

As primary care physicians I agree we have to provide emergency

availability ...

but the key is emergency..

the availability that is being provided as ncbf is round the clock

nonemergency convenience access

I agree about taking our call and being available and that it is easier to

cover yourself than be in large call group, etc. However, how come

specialists are not held to the same standards? Our local cardiologist puts

on his machine to contact your primary doctor after hours if you need

anything. A local psychiatrist cancelled my patient's appointment and when

she called to get a refill of her medicine, the message said to go to ER if

you need medications. When she went to the office for the follow up

appointment, there was a note on the door saying there was a family

emergency and if you need medications, go to the ER. They did not even try

to call her to cancel the appointment. Last summer I got a call and when I

answered it, it was a local HMO I participate with testing to see how long

it took for me to call back.

Just my two cents!

Margaret

Re: " non covered " benefits (revisited)

I don't like the " wink, wink " aspect either. I've struggled with that and

don't

have it totally figured out yet. I have not implemented this concept yet so

its

still a work in progress. Talking about it here is helpful, so thank you.

I do have a subscription website which I really enjoy doing, but it is what

I

describe as a coaching website for " healthy habits " (and weight loss but we

don't focus on that aspect). There is no significant one-on-one

communication

via this website.

In regard to the practice subscription website concept, I would love to

deliver

part of the primary care package this way. The health info/education is " my

take " on how my patients can be healthier. So it would be a lot like my

healthy

habits site in that regard but more directly interactive with the " virtual

communication " . How to frame it? Perhaps I would say that this is one method

that I offer, in addition to traditional office visits, to provide the best

possible care and information to the patients who are interested in

optimizing

their health. Most of my patients love the fact that I spend so much of

their

visit providing them information they can use to improve their health, the

subscription website would be a way to expand on that. Rather than saying I

only offer the web/phone visits through the site, I might explain that the

site

provides the mechanism to have an ongoing 'virtual conversation' between

myself

and the subscriber/patient. I could then choose to still offer traditional

virtual visits that are more limited in scope to non-subscribers as I have

been

doing currently (if I found it worthwhile to continue).

Here are some examples of what I consider 'ongoing conversations': I have

one

patient who loves to update me on every symptom she has on a regular basis

by

email. I counted a total of what could have possibly been 17 billed visits

over

a nine month period via emails (each possible visit being several emails

back

and forth per visit) - none of which I billed because I cannot say where one

visit begins or ends. Nor would she have tolerated being billed 17 times.

Others want me to tell them what screening labs to do through their

extensive

workplace screening program ... which means I have to review their chart to

see

what needs updating, what other labs offered (like 25(OH)D, B12, estradiol,

VAP

etc) might be appropriate for them. Then, they want me to phone them (or

email)

about their results for free. I prescribe a lot of hormones and some

patients

often need more hand-holding than others and want a more continuous

conversation. These are just a few examples of what could be done in that

'ongoing conversation' vs simply telling these folks to come in to the

office to

discuss these things.

These services could be delivered as part of a membership practice like

's, but I'm not allowed to do that in this state. Or, it could be

part

of Jean's dollar a day offer- but again, I cannot do that here. Overall, I

see

it as a hybrid version of a practice like 's- still taking insurance

for

office visits but providing the more continuous stream of care and

information

via the subscription.

To drone on a bit more in relation to the content that could be provided...

[Guest guest]

I think that I will do something similar with my NCBF when it comes up for

renewal in a few months. I had planned on this initially, but in discussion with

patients, some of them convinced me that any appearance of a two-tiered system

could lead to some patients feeling they are receiving substandard service, even

if they were not. But requiring the NCBF is feeling scarier all the time.

I agree that you've got to be careful about the phone call charges. Can't charge

for any phone time that relates to a past or future office visit.

I think I will charge for the same things mentioned, and charge enough

that the annual fee will be a bargain. And I will feel that is fair because of

the time and stress of the piecemeal billing.

Haresch

www.onefamilydoctor.com

>

> Good discussion.

> Over the past 2 weeks I have contemplated the issue of altruism and the

business of a medical practice - Brady's comments really made me stop and

review if I'm experiencing " mission-drift " . What we strive for is a balance - a

healthy business and a healthy doctor. The business acumen and self-advocacy so

that we are compensated for the work we do but also the general peace of mind to

practice regular acts of, yes, altruism in this same practice. Fairness and

good care is the goal.

> So I have mailed out letters and forms to all my patients, laying out my

service and give them " choices " about how to pay for it. I'll include the link

below. I have a little internal conflict about the possibility of a barrier to

care, but I would like to point out to the group (slightly defensive) that my

model is not two tiered. There are problems with it, but the key element of

fairness my plan is that everyone gets the same level of access, the difference

is that I give people the choice of paying for it monthly (at a savings and

discount) or per episode of use(customary fees apply). The access to me is the

same, my phone numbers are all accessible to everyone. When insurance starts

reimbursing evisits (don't know of any now) there will be issues to work out.

> I wonder if there are providers on this listserv who feel that we shouldn't

charge anything to " be on call " . I was trained to devote myself to my patients

welfare, and it has been hard to decide to charge for something that docs have

been donating for decades. But when I look around I see call groups of 10 to 20

doctors - and I know that calling one of those docs at night is McMedicine and

pales in comparison to talking to a familiar person who knows you and cares

about you. And if I don't bill, I might eventually sign on to one of those

mcmedicine call panels.

> I then think that charging for this kind of access is the right way to

preserve this old fashioned touch.

> As far as encroaching on insurance, insurance is (from wiki) " a form of risk

management primarily used to hedge against the risk of a contingent, uncertain

loss. Insurance is defined as the equitable transfer of the risk of a loss, from

one entity to another, in exchange for payment. "

> If it is a service (not monetary compensation) that you clearly CAN provide to

all patients who want it (24x7 access and phone calls/emails - which is for a

finite number of patients such as 500, not 5 zillion) AND there is no element of

the tranaction involving the hedging of risk, then I believe there is no

insurance being sold. How could this be a " promised reimbursable medical care

that cannot be delivered. " If we can not deliver this than we should be

limiting our patient census anyway - fielding medical concerns and questions and

communicating is what we do, we just can't always get paid for it when we are

should.

>

https://sites.google.com/a/stewmonesmd.com/www-maitreefamilymedicine-com/Home/fo\

rm-download-page

> Click and Check out HealthyAccess 2011 policies for my NCBF choices

>

> Stew

> Maitree Family Medicine

> Solo for 18 months

[Guest guest]

I think that I will do something similar with my NCBF when it comes up for

renewal in a few months. I had planned on this initially, but in discussion with

patients, some of them convinced me that any appearance of a two-tiered system

could lead to some patients feeling they are receiving substandard service, even

if they were not. But requiring the NCBF is feeling scarier all the time.

I agree that you've got to be careful about the phone call charges. Can't charge

for any phone time that relates to a past or future office visit.

I think I will charge for the same things mentioned, and charge enough

that the annual fee will be a bargain. And I will feel that is fair because of

the time and stress of the piecemeal billing.

Haresch

www.onefamilydoctor.com

>

> Good discussion.

> Over the past 2 weeks I have contemplated the issue of altruism and the

business of a medical practice - Brady's comments really made me stop and

review if I'm experiencing " mission-drift " . What we strive for is a balance - a

healthy business and a healthy doctor. The business acumen and self-advocacy so

that we are compensated for the work we do but also the general peace of mind to

practice regular acts of, yes, altruism in this same practice. Fairness and

good care is the goal.

> So I have mailed out letters and forms to all my patients, laying out my

service and give them " choices " about how to pay for it. I'll include the link

below. I have a little internal conflict about the possibility of a barrier to

care, but I would like to point out to the group (slightly defensive) that my

model is not two tiered. There are problems with it, but the key element of

fairness my plan is that everyone gets the same level of access, the difference

is that I give people the choice of paying for it monthly (at a savings and

discount) or per episode of use(customary fees apply). The access to me is the

same, my phone numbers are all accessible to everyone. When insurance starts

reimbursing evisits (don't know of any now) there will be issues to work out.

> I wonder if there are providers on this listserv who feel that we shouldn't

charge anything to " be on call " . I was trained to devote myself to my patients

welfare, and it has been hard to decide to charge for something that docs have

been donating for decades. But when I look around I see call groups of 10 to 20

doctors - and I know that calling one of those docs at night is McMedicine and

pales in comparison to talking to a familiar person who knows you and cares

about you. And if I don't bill, I might eventually sign on to one of those

mcmedicine call panels.

> I then think that charging for this kind of access is the right way to

preserve this old fashioned touch.

> As far as encroaching on insurance, insurance is (from wiki) " a form of risk

management primarily used to hedge against the risk of a contingent, uncertain

loss. Insurance is defined as the equitable transfer of the risk of a loss, from

one entity to another, in exchange for payment. "

> If it is a service (not monetary compensation) that you clearly CAN provide to

all patients who want it (24x7 access and phone calls/emails - which is for a

finite number of patients such as 500, not 5 zillion) AND there is no element of

the tranaction involving the hedging of risk, then I believe there is no

insurance being sold. How could this be a " promised reimbursable medical care

that cannot be delivered. " If we can not deliver this than we should be

limiting our patient census anyway - fielding medical concerns and questions and

communicating is what we do, we just can't always get paid for it when we are

should.

>

https://sites.google.com/a/stewmonesmd.com/www-maitreefamilymedicine-com/Home/fo\

rm-download-page

> Click and Check out HealthyAccess 2011 policies for my NCBF choices

>

> Stew

> Maitree Family Medicine

> Solo for 18 months

[Guest guest]

Carla,Help me think this through.I was looking at kikmessenger http://kik.com/ So members who pay would have access to me through kik.

simple- nobody has less access. some just have more access..and I could sell it as platform maintenance fees rather than technology or medical care?

I would appreciate your feedback

 

Stew,I've been thinking about this issue for about 10 years.  I'm in Montana and my contacts with the insurance commissioner here has not been favorable when trying to negotiate some sort of access plan- even if paid in arrears by patients or employers.  After reading your previous emails and thinking a bit more about how my patients access me, I do think a two tiered system is the way to go.

I've struggled with the NCBF idea because yes, I am 24-7 for all my patients - so what part is non-covered?  I've provided email and phone visits beyond what I should have, as I'm a bit of a patsy.  That has changed and I now either direct them through my official Virtual Visit system or ask them to make an office appointment.   I have some insurers who are covering email

and phone visits... which makes things complicated.My solution, which I am considering implementing, is to have a subscription website for my patients.  I have already created a Joomla-based subscription website for a health coaching program I am offering, and when I saw  how that worked, I realized I could do the same for my practice.  The content available to 'subscribers' would be helpful information re: current health news, my advice on cholesterol, vitamins, nutrition, sunscreen, yada yada.  The subscription site would provide the secure contact forms for phone visits and email visits (at no additional charge above the subscription fee).  Patients without a subscription would still be able to access limited parts of the site such as appointments and contact info... but they would not be able to access email or phone visits and thus, would need to make an office visit.  This creates a clean system- either in or

out and I don't have to keep track (the only way to request an email or phone visit will be if they are a subscriber).  Payments for the subscription site are handled by a module in the site and automatically notify them of expiration.

I believe that this set up eliminates my risk in regards to a NCBF... where some insurance company would say I have to be available by phone within reason to all patients, or where some insurance plans are covering email and phone visits and thus, those servcies could not be included in a NCBF for those beneficiaries.   In my mind, the subscription access to the enhanced website content is clearly a non-medical service and is non-covered. They will also receive newsletters with extra content.  And the benefit of having access to set up email and phone visits versus having to come in for an office visit seems like it would be considered valuable for many of my patients.  And its very much

the way I want to interact with patients- sending out info of value to them and interacting with them as appropriate outside the office.The only hitch I can foresee in my plan might be that an insurer could say that I have to offer all patients the same services. Not sure if that is in any of my contracts or not.  I don't think it would be an issue since technically all patients are offered the subscription service... and I don't think they can argue about the email and phone visits if I don't charge for them specifically.

The cost of such a website is minimal.  Joomla is free and generally easy to set up on a server.  It then takes a bit to figure out how to load content, but once you understand it, its easy and very adaptable on the fly.  The subscription management module would be the only purchase other than website hosting you would need to make if you were interested in a similar set

up.Carla

To:

Sent: Mon, January 10, 2011 4:51:02 PMSubject: " non covered " benefits (revisited)

 

I modified my HealthyAccess (non-covered benefit fee-NCBF)in 2011 because Regence BC/BS took issue with patients not having a choice. (This came about due to a complaint from a non-patient who has not been heard from since he filed the complaint with BCBS)

New plan is to allow patients to choose:

A) Healthyaccess 24x7 unlimited communication by phone or email with doc(me) for $100/year,

waive HealthyAccess (the unlimited communication part). Still get 24 x 7 access but have to pay $4/minute after hours and $10 per email. (if not related to an office visit, prescription refill, or scheduling an office visit)

I still feel strongly that getting paid a small stipend to be personally " on call " 24 x 7 for my patients and be willing to talk and email on the small stuff without forcing office visits is a worthwhile service. I don't feel good about plan B because I didn't want two tiers, but I feel forced to offer it and I'm hoping that not too many patients choose it. Would rather open the flood gates to communication then shut it down, but I feel like I've got to provide an alternative in order to work with BC/BS and it wasn't worth leaving BC/BS over it. Nor do I want to ditch the NCBF which I think any other professional giving this level of service would require from clients/patients.

I would appreciate any and all feedback from the group.

Stew Mones

If anyone believes that the OIG would take issue with this set up, let me know or send me a link to check out. Thanks

-- -- Sangeetha Murthy M.D7830 mont Mesa Blvd #287San Diego, CA 92111www.mypcponline.com

PS PATIENTS-please remember  that email may not be entirely secure, Email is best used for brief  questions

Email replies can be expected within 24 hours-Please CALL  if the  matter is more urgent .

[Guest guest]

A subscription, information-only website is a valuable service, coaching,

newsletters, general questions answered. Etc. And it is clean and separate from

all types of covered services - but isn't really a stand-apart-from-the-practice

service? Practically a side business?

I think offering information: advice, newsletters, weighing in on subjects like

supplements, vaccine recommendations and thowing in the doctor's opinion on some

controversial issues is a service that many patients will pay for, not just your

own patients. A subscription service where general information only flows out

is also not " practicing medicine " so the subscribers can be non-patients and

might really take off and become popular - could be a lucrative side business.

I think of that more as separate from ones clinic practice except that when a

subscriber is also a patient, they get the added benefit that they can schedule

an e-visit with you.

I know there are services of providing e-care to people you have never met face

to face (my brother provides this through Legacy's urgent care in Portland) but

I don't plan on crossing that line.

I think a subscription informational website is great and I would like to offer

that eventually, but then it's not patients paying for getting access to you

(and you alone) 24x7.

Stew

Re: " non covered " benefits (revisited)

Carla,

Help me think this through.

I was looking at kikmessenger http://kik.com/ So members who pay would have

access to me through kik.

simple- nobody has less access. some just have more access..

and I could sell it as platform maintenance fees rather than technology or

medical care?

I would appreciate your feedback

>

>

> Stew,

>

> I've been thinking about this issue for about 10 years. I'm in Montana and

> my contacts with the insurance commissioner here has not been favorable when

> trying to negotiate some sort of access plan- even if paid in arrears by

> patients or employers. After reading your previous emails and thinking a

> bit more about how my patients access me, I do think a two tiered system is

> the way to go.

>

> I've struggled with the NCBF idea because yes, I am 24-7 for all my

> patients - so what part is non-covered? I've provided email and phone

> visits beyond what I should have, as I'm a bit of a patsy. That has changed

> and I now either direct them through my official Virtual Visit system or ask

> them to make an office appointment. I have some insurers who are covering

> email and phone visits... which makes things complicated.

>

> My solution, which I am considering implementing, is to have a subscription

> website for my patients. I have already created a Joomla-based subscription

> website for a health coaching program I am offering, and when I saw how

> that worked, I realized I could do the same for my practice. The content

> available to 'subscribers' would be helpful information re: current health

> news, my advice on cholesterol, vitamins, nutrition, sunscreen, yada yada

[Guest guest]

A subscription, information-only website is a valuable service, coaching,

newsletters, general questions answered. Etc. And it is clean and separate from

all types of covered services - but isn't really a stand-apart-from-the-practice

service? Practically a side business?

I think offering information: advice, newsletters, weighing in on subjects like

supplements, vaccine recommendations and thowing in the doctor's opinion on some

controversial issues is a service that many patients will pay for, not just your

own patients. A subscription service where general information only flows out

is also not " practicing medicine " so the subscribers can be non-patients and

might really take off and become popular - could be a lucrative side business.

I think of that more as separate from ones clinic practice except that when a

subscriber is also a patient, they get the added benefit that they can schedule

an e-visit with you.

I know there are services of providing e-care to people you have never met face

to face (my brother provides this through Legacy's urgent care in Portland) but

I don't plan on crossing that line.

I think a subscription informational website is great and I would like to offer

that eventually, but then it's not patients paying for getting access to you

(and you alone) 24x7.

Stew

Re: " non covered " benefits (revisited)

Carla,

Help me think this through.

I was looking at kikmessenger http://kik.com/ So members who pay would have

access to me through kik.

simple- nobody has less access. some just have more access..

and I could sell it as platform maintenance fees rather than technology or

medical care?

I would appreciate your feedback

>

>

> Stew,

>

> I've been thinking about this issue for about 10 years. I'm in Montana and

> my contacts with the insurance commissioner here has not been favorable when

> trying to negotiate some sort of access plan- even if paid in arrears by

> patients or employers. After reading your previous emails and thinking a

> bit more about how my patients access me, I do think a two tiered system is

> the way to go.

>

> I've struggled with the NCBF idea because yes, I am 24-7 for all my

> patients - so what part is non-covered? I've provided email and phone

> visits beyond what I should have, as I'm a bit of a patsy. That has changed

> and I now either direct them through my official Virtual Visit system or ask

> them to make an office appointment. I have some insurers who are covering

> email and phone visits... which makes things complicated.

>

> My solution, which I am considering implementing, is to have a subscription

> website for my patients. I have already created a Joomla-based subscription

> website for a health coaching program I am offering, and when I saw how

> that worked, I realized I could do the same for my practice. The content

> available to 'subscribers' would be helpful information re: current health

> news, my advice on cholesterol, vitamins, nutrition, sunscreen, yada yada

[Guest guest]

A subscription, information-only website is a valuable service, coaching,

newsletters, general questions answered. Etc. And it is clean and separate from

all types of covered services - but isn't really a stand-apart-from-the-practice

service? Practically a side business?

I think offering information: advice, newsletters, weighing in on subjects like

supplements, vaccine recommendations and thowing in the doctor's opinion on some

controversial issues is a service that many patients will pay for, not just your

own patients. A subscription service where general information only flows out

is also not " practicing medicine " so the subscribers can be non-patients and

might really take off and become popular - could be a lucrative side business.

I think of that more as separate from ones clinic practice except that when a

subscriber is also a patient, they get the added benefit that they can schedule

an e-visit with you.

I know there are services of providing e-care to people you have never met face

to face (my brother provides this through Legacy's urgent care in Portland) but

I don't plan on crossing that line.

I think a subscription informational website is great and I would like to offer

that eventually, but then it's not patients paying for getting access to you

(and you alone) 24x7.

Stew

Re: " non covered " benefits (revisited)

Carla,

Help me think this through.

I was looking at kikmessenger http://kik.com/ So members who pay would have

access to me through kik.

simple- nobody has less access. some just have more access..

and I could sell it as platform maintenance fees rather than technology or

medical care?

I would appreciate your feedback

>

>

> Stew,

>

> I've been thinking about this issue for about 10 years. I'm in Montana and

> my contacts with the insurance commissioner here has not been favorable when

> trying to negotiate some sort of access plan- even if paid in arrears by

> patients or employers. After reading your previous emails and thinking a

> bit more about how my patients access me, I do think a two tiered system is

> the way to go.

>

> I've struggled with the NCBF idea because yes, I am 24-7 for all my

> patients - so what part is non-covered? I've provided email and phone

> visits beyond what I should have, as I'm a bit of a patsy. That has changed

> and I now either direct them through my official Virtual Visit system or ask

> them to make an office appointment. I have some insurers who are covering

> email and phone visits... which makes things complicated.

>

> My solution, which I am considering implementing, is to have a subscription

> website for my patients. I have already created a Joomla-based subscription

> website for a health coaching program I am offering, and when I saw how

> that worked, I realized I could do the same for my practice. The content

> available to 'subscribers' would be helpful information re: current health

> news, my advice on cholesterol, vitamins, nutrition, sunscreen, yada yada

[Guest guest]

I meant to ask - isn't it really a stand-apart-from-the-practice service?

Stew

Re: " non covered " benefits (revisited)

Carla,

Help me think this through.

I was looking at kikmessenger http://kik.com/ So members who pay would have

access to me through kik.

simple- nobody has less access. some just have more access..

and I could sell it as platform maintenance fees rather than technology or

medical care?

I would appreciate your feedback

>

>

> Stew,

>

> I've been thinking about this issue for about 10 years. I'm in Montana and

> my contacts with the insurance commissioner here has not been favorable when

> trying to negotiate some sort of access plan- even if paid in arrears by

> patients or employers. After reading your previous emails and thinking a

> bit more about how my patients access me, I do think a two tiered system is

> the way to go.

>

> I've struggled with the NCBF idea because yes, I am 24-7 for all my

> patients - so what part is non-covered? I've provided email and phone

> visits beyond what I should have, as I'm a bit of a patsy. That has changed

> and I now either direct them through my official Virtual Visit system or ask

> them to make an office appointment. I have some insurers who are covering

> email and phone visits... which makes things complicated.

>

> My solution, which I am considering implementing, is to have a subscription

> website for my patients. I have already created a Joomla-based subscription

> website for a health coaching program I am offering, and when I saw how

> that worked, I realized I could do the same for my practice. The content

> available to 'subscribers' would be helpful information re: current health

> news, my advice on cholesterol, vitamins, nutrition, sunscreen, yada yada

[Guest guest]

I meant to ask - isn't it really a stand-apart-from-the-practice service?

Stew

Re: " non covered " benefits (revisited)

Carla,

Help me think this through.

I was looking at kikmessenger http://kik.com/ So members who pay would have

access to me through kik.

simple- nobody has less access. some just have more access..

and I could sell it as platform maintenance fees rather than technology or

medical care?

I would appreciate your feedback

>

>

> Stew,

>

> I've been thinking about this issue for about 10 years. I'm in Montana and

> my contacts with the insurance commissioner here has not been favorable when

> trying to negotiate some sort of access plan- even if paid in arrears by

> patients or employers. After reading your previous emails and thinking a

> bit more about how my patients access me, I do think a two tiered system is

> the way to go.

>

> I've struggled with the NCBF idea because yes, I am 24-7 for all my

> patients - so what part is non-covered? I've provided email and phone

> visits beyond what I should have, as I'm a bit of a patsy. That has changed

> and I now either direct them through my official Virtual Visit system or ask

> them to make an office appointment. I have some insurers who are covering

> email and phone visits... which makes things complicated.

>

> My solution, which I am considering implementing, is to have a subscription

> website for my patients. I have already created a Joomla-based subscription

> website for a health coaching program I am offering, and when I saw how

> that worked, I realized I could do the same for my practice. The content

> available to 'subscribers' would be helpful information re: current health

> news, my advice on cholesterol, vitamins, nutrition, sunscreen, yada yada

[Guest guest]

Stew,I believe people are trying to find something to charge for to subsidize their practices; so, you are correct, it could be separate, but as part of the practice that insurance doesn't pay for, perhaps patients would be willing to.

I see it as a possibility for those who want to do primary care, but aren't subsidized by a hospital or multi-specialty group, don't want to do cosmetic stuff or moon-light.

Maybe people not in the practice could also pay for the newsletter, and thereby help the primary care practice along even more.SharonSharon McCoy MDRenaissance Family Medicine

10 McClintock Court; Irvine, CA  92617PH: (949)387-5504   Fax: (949)281-2197  Toll free phone/fax:  www.SharonMD.com

 

I meant to ask - isn't it really a stand-apart-from-the-practice service?

Stew

Re: " non covered " benefits (revisited)

Carla,

Help me think this through.

I was looking at kikmessenger http://kik.com/ So members who pay would have

access to me through kik.

simple- nobody has less access. some just have more access..

and I could sell it as platform maintenance fees rather than technology or

medical care?

I would appreciate your feedback

>

>

> Stew,

>

> I've been thinking about this issue for about 10 years. I'm in Montana and

> my contacts with the insurance commissioner here has not been favorable when

> trying to negotiate some sort of access plan- even if paid in arrears by

> patients or employers. After reading your previous emails and thinking a

> bit more about how my patients access me, I do think a two tiered system is

> the way to go.

>

> I've struggled with the NCBF idea because yes, I am 24-7 for all my

> patients - so what part is non-covered? I've provided email and phone

> visits beyond what I should have, as I'm a bit of a patsy. That has changed

> and I now either direct them through my official Virtual Visit system or ask

> them to make an office appointment. I have some insurers who are covering

> email and phone visits... which makes things complicated.

>

> My solution, which I am considering implementing, is to have a subscription

> website for my patients. I have already created a Joomla-based subscription

> website for a health coaching program I am offering, and when I saw how

> that worked, I realized I could do the same for my practice. The content

> available to 'subscribers' would be helpful information re: current health

> news, my advice on cholesterol, vitamins, nutrition, sunscreen, yada yada

[Guest guest]

Stew,I believe people are trying to find something to charge for to subsidize their practices; so, you are correct, it could be separate, but as part of the practice that insurance doesn't pay for, perhaps patients would be willing to.

I see it as a possibility for those who want to do primary care, but aren't subsidized by a hospital or multi-specialty group, don't want to do cosmetic stuff or moon-light.

Maybe people not in the practice could also pay for the newsletter, and thereby help the primary care practice along even more.SharonSharon McCoy MDRenaissance Family Medicine

10 McClintock Court; Irvine, CA  92617PH: (949)387-5504   Fax: (949)281-2197  Toll free phone/fax:  www.SharonMD.com

 

I meant to ask - isn't it really a stand-apart-from-the-practice service?

Stew

Re: " non covered " benefits (revisited)

Carla,

Help me think this through.

I was looking at kikmessenger http://kik.com/ So members who pay would have

access to me through kik.

simple- nobody has less access. some just have more access..

and I could sell it as platform maintenance fees rather than technology or

medical care?

I would appreciate your feedback

>

>

> Stew,

>

> I've been thinking about this issue for about 10 years. I'm in Montana and

> my contacts with the insurance commissioner here has not been favorable when

> trying to negotiate some sort of access plan- even if paid in arrears by

> patients or employers. After reading your previous emails and thinking a

> bit more about how my patients access me, I do think a two tiered system is

> the way to go.

>

> I've struggled with the NCBF idea because yes, I am 24-7 for all my

> patients - so what part is non-covered? I've provided email and phone

> visits beyond what I should have, as I'm a bit of a patsy. That has changed

> and I now either direct them through my official Virtual Visit system or ask

> them to make an office appointment. I have some insurers who are covering

> email and phone visits... which makes things complicated.

>

> My solution, which I am considering implementing, is to have a subscription

> website for my patients. I have already created a Joomla-based subscription

> website for a health coaching program I am offering, and when I saw how

> that worked, I realized I could do the same for my practice. The content

> available to 'subscribers' would be helpful information re: current health

> news, my advice on cholesterol, vitamins, nutrition, sunscreen, yada yada

[Guest guest]

Stew,I believe people are trying to find something to charge for to subsidize their practices; so, you are correct, it could be separate, but as part of the practice that insurance doesn't pay for, perhaps patients would be willing to.

I see it as a possibility for those who want to do primary care, but aren't subsidized by a hospital or multi-specialty group, don't want to do cosmetic stuff or moon-light.

Maybe people not in the practice could also pay for the newsletter, and thereby help the primary care practice along even more.SharonSharon McCoy MDRenaissance Family Medicine

10 McClintock Court; Irvine, CA  92617PH: (949)387-5504   Fax: (949)281-2197  Toll free phone/fax:  www.SharonMD.com

 

I meant to ask - isn't it really a stand-apart-from-the-practice service?

Stew

Re: " non covered " benefits (revisited)

Carla,

Help me think this through.

I was looking at kikmessenger http://kik.com/ So members who pay would have

access to me through kik.

simple- nobody has less access. some just have more access..

and I could sell it as platform maintenance fees rather than technology or

medical care?

I would appreciate your feedback

>

>

> Stew,

>

> I've been thinking about this issue for about 10 years. I'm in Montana and

> my contacts with the insurance commissioner here has not been favorable when

> trying to negotiate some sort of access plan- even if paid in arrears by

> patients or employers. After reading your previous emails and thinking a

> bit more about how my patients access me, I do think a two tiered system is

> the way to go.

>

> I've struggled with the NCBF idea because yes, I am 24-7 for all my

> patients - so what part is non-covered? I've provided email and phone

> visits beyond what I should have, as I'm a bit of a patsy. That has changed

> and I now either direct them through my official Virtual Visit system or ask

> them to make an office appointment. I have some insurers who are covering

> email and phone visits... which makes things complicated.

>

> My solution, which I am considering implementing, is to have a subscription

> website for my patients. I have already created a Joomla-based subscription

> website for a health coaching program I am offering, and when I saw how

> that worked, I realized I could do the same for my practice. The content

> available to 'subscribers' would be helpful information re: current health

> news, my advice on cholesterol, vitamins, nutrition, sunscreen, yada yada

[Guest guest]

How can a small practice profitably produce a quality newsletter? It takes creativity I don’t have to write good material not to mention keeping it fresh. Already there are hundreds of medical news sources. I get many offers in the mail targeting the general public for everything from alternative approaches to newsletters branded by major hospitals not to mention dozens of slick web sites offering free information (familydoctor.org, webmd.com, etc). Granted I may believe I have something better to offer but what’s to make me stand out as more valuable in my patient’s mind than the nearly infinite resources on the web. No way I will find time to produce the professional looking materials these other sources are already offering free. Really, what’s to offer that’s not already free on the web? I’m guessing you need an audience much bigger than solo practices have to justify the resources for a vibrant newsletter or creative informational web site. A free newsletter or free web site as a marketing tool makes sense to me. I don’t see my patients buying a newsletter from me. Just asking. Neighbors, MDHuntsville, Alabama DocNeighbors.com From: [mailto: ] On Behalf Of Sharon McCoy Sent: Sunday, January 30, 2011 3:32 PMTo: Subject: Re: " non covered " benefits (revisited) Stew, I believe people are trying to find something to charge for to subsidize their practices; so, you are correct, it could be separate, but as part of the practice that insurance doesn't pay for, perhaps patients would be willing to. I see it as a possibility for those who want to do primary care, but aren't subsidized by a hospital or multi-specialty group, don't want to do cosmetic stuff or moon-light. Maybe people not in the practice could also pay for the newsletter, and thereby help the primary care practice along even more. SharonSharon McCoy MDRenaissance Family Medicine10 McClintock Court; Irvine, CA 92617PH: (949)387-5504 Fax: (949)281-2197 Toll free phone/fax: www.SharonMD.com I meant to ask - isn't it really a stand-apart-from-the-practice service?Stew Re: " non covered " benefits (revisited)Carla,Help me think this through.I was looking at kikmessenger http://kik.com/ So members who pay would haveaccess to me through kik.simple- nobody has less access. some just have more access..and I could sell it as platform maintenance fees rather than technology ormedical care?I would appreciate your feedback>>> Stew,>> I've been thinking about this issue for about 10 years. I'm in Montana and> my contacts with the insurance commissioner here has not been favorable when> trying to negotiate some sort of access plan- even if paid in arrears by> patients or employers. After reading your previous emails and thinking a> bit more about how my patients access me, I do think a two tiered system is> the way to go.>> I've struggled with the NCBF idea because yes, I am 24-7 for all my> patients - so what part is non-covered? I've provided email and phone> visits beyond what I should have, as I'm a bit of a patsy. That has changed> and I now either direct them through my official Virtual Visit system or ask> them to make an office appointment. I have some insurers who are covering> email and phone visits... which makes things complicated.>> My solution, which I am considering implementing, is to have a subscription> website for my patients. I have already created a Joomla-based subscription> website for a health coaching program I am offering, and when I saw how> that worked, I realized I could do the same for my practice. The content> available to 'subscribers' would be helpful information re: current health> news, my advice on cholesterol, vitamins, nutrition, sunscreen, yada yada

[Guest guest]

How can a small practice profitably produce a quality newsletter? It takes creativity I don’t have to write good material not to mention keeping it fresh. Already there are hundreds of medical news sources. I get many offers in the mail targeting the general public for everything from alternative approaches to newsletters branded by major hospitals not to mention dozens of slick web sites offering free information (familydoctor.org, webmd.com, etc). Granted I may believe I have something better to offer but what’s to make me stand out as more valuable in my patient’s mind than the nearly infinite resources on the web. No way I will find time to produce the professional looking materials these other sources are already offering free. Really, what’s to offer that’s not already free on the web? I’m guessing you need an audience much bigger than solo practices have to justify the resources for a vibrant newsletter or creative informational web site. A free newsletter or free web site as a marketing tool makes sense to me. I don’t see my patients buying a newsletter from me. Just asking. Neighbors, MDHuntsville, Alabama DocNeighbors.com From: [mailto: ] On Behalf Of Sharon McCoy Sent: Sunday, January 30, 2011 3:32 PMTo: Subject: Re: " non covered " benefits (revisited) Stew, I believe people are trying to find something to charge for to subsidize their practices; so, you are correct, it could be separate, but as part of the practice that insurance doesn't pay for, perhaps patients would be willing to. I see it as a possibility for those who want to do primary care, but aren't subsidized by a hospital or multi-specialty group, don't want to do cosmetic stuff or moon-light. Maybe people not in the practice could also pay for the newsletter, and thereby help the primary care practice along even more. SharonSharon McCoy MDRenaissance Family Medicine10 McClintock Court; Irvine, CA 92617PH: (949)387-5504 Fax: (949)281-2197 Toll free phone/fax: www.SharonMD.com I meant to ask - isn't it really a stand-apart-from-the-practice service?Stew Re: " non covered " benefits (revisited)Carla,Help me think this through.I was looking at kikmessenger http://kik.com/ So members who pay would haveaccess to me through kik.simple- nobody has less access. some just have more access..and I could sell it as platform maintenance fees rather than technology ormedical care?I would appreciate your feedback>>> Stew,>> I've been thinking about this issue for about 10 years. I'm in Montana and> my contacts with the insurance commissioner here has not been favorable when> trying to negotiate some sort of access plan- even if paid in arrears by> patients or employers. After reading your previous emails and thinking a> bit more about how my patients access me, I do think a two tiered system is> the way to go.>> I've struggled with the NCBF idea because yes, I am 24-7 for all my> patients - so what part is non-covered? I've provided email and phone> visits beyond what I should have, as I'm a bit of a patsy. That has changed> and I now either direct them through my official Virtual Visit system or ask> them to make an office appointment. I have some insurers who are covering> email and phone visits... which makes things complicated.>> My solution, which I am considering implementing, is to have a subscription> website for my patients. I have already created a Joomla-based subscription> website for a health coaching program I am offering, and when I saw how> that worked, I realized I could do the same for my practice. The content> available to 'subscribers' would be helpful information re: current health> news, my advice on cholesterol, vitamins, nutrition, sunscreen, yada yada

[Guest guest]

Interesting.

 

How is Eisenhower Primary Care 365 different?â—Š

We are offering a model of primary care that puts you in charge of your health in an efficient and meaningful way with your chosen physician 365 days a year. This relationship-centered care with your physician and care team establishes a relationship beyond office visits. By having continual communication with you, your physician will better understand your health care needs. Extended face-to-face time with your physician, personalized focus on your health concerns, and detailed planning for any chronic conditions that may be part of your health profile are just a few ways you will notice a difference with Eisenhower Primary Care 365.

What is the annual membership fee?

Member Age

 Rate for individual members

Rate per member, if more than one paying member in immediate family*

Children 0-18 if one or more parents are members**

Under 55 years

$395/year

$355/year

$0

56 years and better

$595/year

$555/year

$0

*Immediate family is defined as a single parent and dependent children through age 25 or spouses/registered domestic partners including dependent children through age 25.

**Dependent children ages 19-25 are eligible at the discounted rate when one or more parents are members.

What are the differences between Eisenhower Primary Care 365 and physicians offering concierge service?

Eisenhower Primary Care 365 physicians are always available to you online through RelayHealth and will respond within one business day to routine communication.A concierge physician is always on call for you, 24 hours a day, 7 days a week by phone or in person. An Eisenhower Primary Care 365 physician will become involved with your hospital stay but will usually rely on a hospital-based physician to take charge of your primary management.A concierge physician will see you throughout your hospital stay. Eisenhower Primary Care 365 physicians each take care of 850 to 950 patients. Most primary care practices take care of 2,000 to 3,000 patients. Concierge practices usually limit their patients to only 200 or 300 patients

Locke, MD

 

Thanks Sharon, I will explore it... 

 

Sangeetha,

The article by Joe Scherger that mentioned led me to check out his new practice:  http://www.emc.org/body-e365.cfm?id=415

How is Eisenhower Primary Care 365 different?◊

We are offering a model of primary care that puts you in charge of your health in an efficient and meaningful way with your chosen physician 365 days a year. This relationship-centered care with your physician and care team establishes a relationship beyond office visits. By having continual communication with you, your physician will better understand your health care needs. Extended face-to-face time with your physician, personalized focus on your health concerns, and detailed planning for any chronic conditions that may be part of your health profile are just a few ways you will notice a difference with Eisenhower Primary Care 365.

They seem to call it Primary Care 365 and a " relationship beyond visits. "

It is a good question.

Sharon

-- Sangeetha Murthy M.D

7830 mont Mesa Blvd #287

San Diego, CA 92111

www.mypcponline.com