Concierge Medicine Is Here and Growing!!

Dalen, James E.; Alpert, Joseph S.

doi:10.1016/j.amjmed.2017.03.031

Cited by 11 publications

(11 citation statements)

References 11 publications

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“…20 Part of the reported joy of a DPC practice is that the family physician is able to spend more time with patients and is paid (through monthly fees) to also care and communicate by phone calls, emails, and text messages. [21][22][23] This means that these practices have been freed from the burdens of CPT codes and CMS E&M documentation and billing rules. Given the growth of DPC practices and other possible novel documentation, coding, and billing models, CMS should develop GME payment approaches that are not connected to the CPT codes and it should revise its E&M rules to allow residency clinics to more completely bill for their clinical work.…”

Section: Discussionmentioning

confidence: 99%

Coding Family Medicine Residency Clinic Visits, 99213 or 99214? A Residency Research Network of Texas Study

Young¹,

Holder

Kale

et al. 2019

Fam Med

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Background and Objectives: The purpose of this study was to characterize Current Procedural Terminology (CPT) coding patterns for professional services in family physician (FP) residency clinics. Methods: Trained assistants directly observed during every other FP-patient encounter in 10 clinics affiliated with eight residencies of the Residency Research Network of Texas. Three investigators later independently coded each visit for the highest code level reasonably allowed. The primary outcome was the number of clinic visits that were actually coded as a CPT 99203/213 that could have been coded at a higher level. Results: In 850 physician-patient encounters where the CPT code billed was identified, the investigators completely agreed on the allowable code 93% of the time. Overall, a 99203/13 or lower or preventive services code was billed in 651 visits (76.6%), more commonly in resident visits (515/570 [90.4%] vs 136/280 for faculty [48.6%], P<.001). There were 476/660 (72.1%) visits coded at a 99213 or less that could have been coded as a 99204/214 or higher. This was more common in resident visits 385/434 (88.7%), but there was undercoding in faculty patients as well 91/226 (40.3%). We found very few cases of overcoding—16 total. Conclusions and relevance: FPs coding patient encounters in residency clinics undercode for their work, which leads to decreased clinic revenue. This may be because the primary care exception is felt to be too onerous to bill for higher-paid codes, or a lack of knowledge of CMS coding rules among residents and faculty, or other reasons.

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Section: Discussionmentioning

confidence: 99%

Coding Family Medicine Residency Clinic Visits, 99213 or 99214? A Residency Research Network of Texas Study

Young¹,

Holder

Kale

et al. 2019

Fam Med

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“…18,19 At the same time, more physicians, particularly those providing primary care, are considering or have moved into concierge practice in response to treatment time constraints and work effort-compensation concerns. 20,21 In light of structural changes in the physician labor market, we report on a national survey of practicing physicians that assessed their perceptions of pay fairness. Specifically, we hypothesized that physicians who think their compensation is fair will be more satisfied at work, be less inclined to leave their medical practice, and report having better overall health.…”

Section: Introductionmentioning

confidence: 99%

Physician Perception of Pay Fairness and its Association with Work Satisfaction, Intent to Leave Practice, and Personal Health

et al. 2018

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“…8 Medical Evaluation and Treatment Unit, WHMU, Washington D.C., USA. 9 The White House Medical Unit (WHMU), Washington, D.C., USA. 10 Department of Emergency Medicine, Medical College of Georgia, Augusta University, Augusta, USA.…”

Section: Acknowledgementsmentioning

confidence: 99%

“…Dignitary medicine (DM) is often provided by government-appointed officials (such as the White House Medical Unit in the United States or the Royal Physicians in Saudi Arabia), consulting groups of self-identified experts, clinics marketed toward VIPs (Cleveland Clinic, Mayo Clinic, etc. ), or by private concierge doctors [9].These providers often come from a variety of backgrounds, with very little standardization in their training or backgrounds.…”

Section: Introductionmentioning

confidence: 99%

A dignitary medicine curriculum developed using a modified Delphi methodology

Mulhim

Darling²,

Sarin

et al. 2020

Int J Emerg Med

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Background: Dignitary medicine is an emerging field of training that involves the specialized care of diplomats, heads of state, and other high-ranking officials. In an effort to provide guidance on training in this nascent field, we convened a panel of experts in dignitary medicine and using the Delphi methodology, created a consensus curriculum for training in dignitary medicine. Methods: A three-round Delphi consensus process was performed with 42 experts in the field of dignitary medicine. Predetermined scores were required for an aspect of the curriculum to advance to the next round. The scores on the final round were used to determine the components of the curriculum. Scores below the threshold to advance were dropped in the subsequent round. Results: Our panel had a high degree of agreement on the required skills needed to practice dignitary medicine, with active practice in a provider's baseline specialty, current board certification, and skills in emergency care and resuscitation being the highest rated skills dignitary medicine physicians need. Skills related to vascular and emergency ultrasound and quality improvement were rated the lowest in the Delphi analysis. No skills were dropped from consideration. Conclusions: The results of our work can form the basis of formal fellowship training, continuing medical education, and publications in the field of dignitary medicine. It is clear that active medical practice and knowledge of resuscitation and emergency care are critical skills in this field, making emergency medicine physicians well suited to practicing dignitary medicine.

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Concierge Medicine Is Here and Growing!!

Cited by 11 publications

References 11 publications

Coding Family Medicine Residency Clinic Visits, 99213 or 99214? A Residency Research Network of Texas Study

Coding Family Medicine Residency Clinic Visits, 99213 or 99214? A Residency Research Network of Texas Study

Physician Perception of Pay Fairness and its Association with Work Satisfaction, Intent to Leave Practice, and Personal Health

A dignitary medicine curriculum developed using a modified Delphi methodology

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