My primary care physician recently switched to a program called MDVIP. You'd better pray it doesn't come to your local doctor's office unless you have a good deal of free cash lying around at your disposal.
MDVIP is a program that focuses on preventive care. It puts your doctor at your beck and call via his pager. You can call him or one of his partners any time, day or night. If you call for an appointment you will get a same day or next day appointment. The appointments can last up to an hour or more. Your medical files all get archived on a mini-CD.
In order to provide this level of care, your doctor has to cut his practice down from 2,000-3,000 patients to 600 patients. What is the criteria for selection? The simplest criteria there is: money. MDVIP costs $1,500 to join. No, that's not a one-time fee to join. That is an annual fee to maintain your membership in the MDVIP program as well as stay a patient of your doctor. This comes out of your own pocket and goes on top of all your insurance payments to your doctor.
MDVIP is simply the next step in the HMO health care model. Get more money out of your patients and do less medical procedures. Offer the best care for those with the most money. Leave those with shallow pockets out in the cold to find their own way. Long time patients politely shown the door because they don't have $1,500 per year to pay directly to their doctor. Since when did belonging to a primary care physician's practice become the equivalent of being a member of a country club, dues and all?
Doctors claim that they are doing this because they want to practice better, more in-depth medicine. I don't buy it. The hefty up-front annual fee is what points me in the direction of the motivation for the doctors. They get more free time because they are dealing with 20% of the patients they used to see and they get $900,000 in dues straight away not counting any money they collect from your insurance provider. Who wouldn't like more vacation time and a raise?
I think that this goes against what doctors are pledged to do which is to help people. The most helpless, those with the least money, get left by the wayside. The rich who have many avenues to seek out medical care get a doctor that is dedicated to them 24-7 because it is more profitable to be the lap dog of 600 wealthy people instead of 3000 people with mostly average monetary means. I think MDVIP is a shameful program that goes against what doctors have pledged to do. This is just another symptom of a society where the wealthy have been in control for too long and have put their own needs ahead of all others.