That’s an optimistic scenario and perhaps that is how it will play out. I am not so sure. There is apparently a lot of burn out. A lot of nurses and probably a fair number of doctors are either just leaving or, if they have the option, retiring.
As I said, we tend to assume that the medical system will “pretty much” just be there for us. I am a lot less confident that this bit of the world will snap back for us if/when covid becomes less of an issue. Wait and see, I guess.
I think you’re being overoptimistic but I will agree that there’s been huge tumult in the doctor’s offices I visit.
In spring 2021 I had an eye surgery done (not quite elective as I was really in need of it, but certainly not emergency) and there were no staff or surgical center shortages. I asked about getting the other eye done last week and was told no way till late this year, they are only doing emergency eye surgeries now on a very restricted schedule due to lack of personnel and all surgeries that are possibly delayed are being scheduled for early fall at the earliest.
In summer 2020 my endo’s office laid off vast numbers of office staff because very few patients wanted to come visit. As a result refills etc. that used to be immediate went into “we’ll try to get to it in the next few weeks” mode, and they completely stopped accepting new patients.
Predating the pandemic, in 2019 my PCP went into “I won’t write any prescriptions at all I will just refer you to specialists” mode and then in summer 2020 went concierge (and no way can I afford $12000 a year to see a doctor who didn’t want to help me with anything before and their big bragging point about going concierge is they now have an in-office A1C machine, I mean like what am I supposed to say, whoopeee, here take my $12000?).
Depending on your age and location, perhaps it would make sense to look at other alternatives, possibly even including ordering your own tests, at least from time to time. Although a full price A1C is $21 at places such as Ulta Labs, they often have promotions and I have seen their A1C discounted to below $10 at times. You can most likely get all the tests you are currently getting through your PCP for well under $150.
I avoid my PCP and deal direct whenever possible, but do need a PCP as a central point of contact to store all medical records and some test results.
Oh, I wasn’t saying that I needed an A1C test (my endo does them all the time) just laughing out loud that my old PCP office think’s it’s a sell point for a $12000 a year concierge conversion.
I was really happy with my old PCP but today you’re right, I’m mostly just in need of having a PCP for the sake of having something to fill out on all my specialist’s forms. Very thankful that I have a deluxe insurance plan where I don’t need a PCP referral for each and every specialist visit. In my area so many traditional PCP’s have gone concierge that you’re looking at 3+ month wait for a new-patient visit (and as I mentioned many endo offices have totally stopped seeing any new patients so basically infinite wait). I can totally see why so many folks don’t have a PCP today and just go straight to the ER or urgent care center in the strip mall for everything, and the pandemic has just accelerated this for the worse.
When I google for the definition of concierge I get something along the lines of “a hotel employee whose job is to assist guests by arranging tours, making theater and restaurant reservations, et cetera”.
I am afraid I have no idea what you are talking about when you refer to your PCP switching to concierge. Could you provide a little more detail about what changes your PCP made? 
Concierge is a new trend in the medical system. It basically means the really good (usually?) doctors are sick of being restrained by our terrible insurance system and are going independent. You pay entirely out of pocket for your visits. Some of them even have a fee just to join their service, like a retainer fee you might pay a lawyer, and then you pay even more for your actual visits. But the payoff is that you get a much better level of care. They can spend more time with their patients and do the tests they want and/or prescribe the medications they want, rather than trying to turn and burn patients within the restrictions instance will allow.
Our favorite doctor in my local clinic did this. She’s amazing! Great bedside manner, actually willing to listen to a patient and give their ideas/research credit, and discuss if Doctor Google was leading them down the wrong path. She embraces natural and preventative medicine, is all about healthy lifestyle changes, but also willing to discuss the pros and cons of prescription options to find the best fit for you. Not just force the fad drug on you But she just wasn’t allowed to do her job right at the clinic. She got so fed up and walked away, went to the next town over and started her own independent practice. No insurance accepted whatsoever. And people are willing to pay out of pocket to see her because she, and the experience, are just that good.
So, in other words “pay to play”? I have no idea how someone thought that somehow equates to concierge. 
Frankly, me either. I think it’s playing to the personal service angle, though.
I do think it’s a good thing in the long run, though. Our medical system is broken. Money people with no medical training whatsoever are dictating how patients are being treated. Being a doctor is no longer the enticing opportunity it once was, when you’re faced with a lifetime of debt and hard work for no payout. Hopefully refusing to play ball at all with the insurance companies will force some reform. Unfortunately, it’s going to hurt those using public insurance big time in the short term.
It’s how wealthy people do healthcare because the system is so horrible and right now everyone struggles with the same system. This gives wealthy people an option to get that no waiting no bill haggling no approvals kind of health care.
It’s just another sign that we are in a country of haves and have nots. And the divide keeps growing.
No average or even upper middle class person could afford that
That’s not entirely true. We used to be upper middle class, but Covid has definitely changed that. We’ve essentially had zero income since the start of the pandemic, because it’s wrecked the pilot industry and still hasn’t recovered. All those furloughed airline pilots flooded the private market, so the pay scale crashed. Now we’re just trying to survive off of what used to be a “hobby farm”.
His cobra benefits recently expired and we had to make a choice about paying out of pocket for a health insurance plan, since he doesn’t qualify for public assistance or the weird “in house” thing I have going on through our clinic (we don’t share money/assets on paper). There’s a little risk, but we decided to forego insurance completely and go concierge with the doctor he liked. It actually turned out to be the more affordable option with cash discounts and not having to pay the premium, deductable, and big copay on marked up prices. The risk comes with mildly serious emergencies. We have to run up a really big hospital bill before it’s worth the cost of insurance, and we have a clause in our farm insurance that pays if we’re physically incapacitated from working the farm. There’s a small window of concern between the two.
Medications were a big part of the deciding factor. Even with insurance one of his asthma inhalers costs $250 a month, more before the deductible is met. They’re marked up worse than our insulins. Even the cheap rescue one costs about $100 w/ insurance. But I can source them much more cost effectively without insurance. At least not with the sucky plans available in the marketplace when we searched.
That is a big risk for a diabetic. I’m glad it’s working for you, but if you get kidney problems or if you eye treatments for retinopathy, it could be devastating.
That’s the only reason I have insurance. I could afford doctors visits and medication without much difficulty.
But when I got cancer at the ripe age of 26, it would have broken the bank. Close to $100,000 and that was 25 years ago.
Lucky for me I have employer provided insurance. I don’t want to have to be in a place I can’t afford my care.
I’m fortunate to have Medicare and a supplement policy. About a year after I signed up for those, I was diagnosed with cancer. So in addition to my insulin, insulin pump supplies, and CPAP supplies, Medicare/supplement had to pay for surgeries (8 so far), to the tune of just over $900K. My out-of-pocket was about $200/year for the Medicare deductible.
And a note about availability of care in my area (East TN), all my providers (every type you can name) have been available to me same day usually, next dat latest. I just can’t complain about the care, just about what they have to treat for me.
Your choice of traditional Medicare plus a supplement policy was fortunate for you. It’s the same choice I made.
Your cancer diagnosis was certainly unfortunate but I’m glad that reality was not made worse with the financial pain of poor insurance coverage.
Thanks for your comment, Rob; it deserves its own thread.