Retainer Medicine A Growing Alternative to Health Insurance

It's a cold, wet winters night - you child's fever is 102 degrees and climbing - suddenly the doorbell rings, and in walks your doctor. No this isn't a dream or a scene from an old movie - that is not if you are a one of the growing thousands of patients who have a doctor on a retainer.

Faced with increased dissatisfaction with the costs private health insurance and the level of treatment and customer service received by most managed care facilities, many people have turned to another alternative: retainer medicine.

The idea, much like retaining the services of other professionals such as lawyers or accounts, is to have a doctor on call - for a fee. By paying an annual flat fee to participating practitioners; usually around $1500.00 -2000.00 annually; patients have access to appointments - even house calls in many cases - as many times, and when ever they need their doctor. It also gives these patients a level of personal care that many complain has been lacking in HMO's, PPO's and large groups practices.

It's been estimated there are about 600 doctors nationwide that have stopped accepting health insurance, and instead charge their patients a monthly or yearly retainer. That is not a large number of physicians, but it is a trend that has been steadily growing. It is not only the "rich and famous" who enjoy the luxury of a "personal physician". Patients love the idea of having a doctor on call who knows their name and their conditions intimately, and doctors on retainer find it easier to set a budget, build their practice to only the number of patients they want, and not have to hassle with third party payers.

A physician on retainer is not a substitute for comprehensive medical insurance. Of course the fees you pay to retain your personal doctor will not cover you for other medical expenses such as surgery or hospitalization. Still it gives many patients who can afford it the personal touch in medicine they desire, and they can actually reduce the cost of health insurance, by taking only a catastrophic health insurance or a major medical plan.

Retainer practice started in Seattle in 1996 according to the American Medical Association, when doctors there sought an alternative to the fees they were getting from insurance companies. There and in other places like California retainer practices have also been called Boutique Medicine, or Concierge Care - and many doctors in such practices deliver services in spa like atmospheres, and charge 15,000 - 20,000 per year. However other doctors such as Dr. Robert Fields, who recently converted to retainer practice in a middle class section of Maryland, object to the term because it sounds elitist. He says he does what he does for the middle class, for the working people who want and deserve better care. Says Fields, "I loathe the terms concierge or boutique practice's. I feel this is about being an old-fashioned doctor. I charge $1,500 a year it is the price of a pack of cigarettes a day, or a Starbucks coffee. I set this up to serve the mailman, the grocery checker, or the housekeeper. It should help the middle class."