Searching for a Doctor, Hair Stylist, and Auto Mechanic
November 13, 2017
In preparing for our move this coming January from our current home in metro Phoenix to our new home in metro Tucson, my wife Kim and I were recently in Tucson to find a new family doctor, a new hair stylist for her, and a new auto mechanic.
These were stressful decisions, for if Kim and I didn't find service providers as good as the ones we've had in Phoenix for decades, we might end up regretting our decision to move. (If any male readers are wondering what's so important about a spouse liking her hair stylist, they've never been married.)
The most difficult search was for a family doctor, because unlike hair stylists and auto mechanics, the government killed a true consumer market in medical care over 70 years ago. This makes it very difficult to compare doctors on price, service and quality.
By definition, a consumer market doesn't exist when someone other than the consumer pays a service provider. In medical care, the payer is typically not the consumer, or patient. Rather, the payer is Medicare, Medicaid, ObamaCare, or an employer's group insurance plan.
Not only that, but doctors have been inflicted over the intervening 70 years with ever-increasing government regulations, reimbursement red tape, and price controls. This is why the typical medical practice has more billing clerks, regulatory consultants, and software coders behind the scenes than doctors and nurses. It's also why doctors have joined large hospital groups, thus becoming hired hands instead of trying to survive as sole practitioners.
The net result is that medical care has become impersonal, rushed, and difficult to schedule. Doctors spend little time with patients and are preoccupied during office visits with entering the proper treatment codes on a laptop or computer notebook. Moreover, an increasing number of doctors no longer accept Medicare patients, for Medicare reimbursements do not cover the cost of treatment.
By contrast, there is an abundance of hair stylists and auto mechanics who want new customers and compete for them on price and service. Fortunately, after getting a referral, Kim found a hair stylist she likes a mile from our new home. Likewise, we found two great options for auto care: an independent garage with a stellar reputation, and a Toyota dealer that has higher prices but a gleaming, modern facility with courteous personnel, as well as a first-class customer waiting area with coffee, snacks, comfortable chairs, Wi-Fi, and TV.
It took a lot more effort to find a good family doctor. We conducted Internet research on the best-ranked docs in Tucson and reviewed their medical schooling, years of experience, age, and proximity to our new house. After narrowing the list, our top choice turned out to be a 50-year-old doctor who shares a concierge practice with another doctor and who accepts new Medicare patients.
A concierge practice is a way for doctors to comply with government and insurance company reimbursement schedules but still compete in a different way on quality and service. For an additional annual concierge fee, their patients get quick appointments, proactive care instead of just reactive care, as much personal time as needed with the doctor, and the ability to contact the doctor directly via email or cellphone.
We decided to drive by the doctor's office to see where it was located and what it looked like from the outside. Impressed by the curb appeal, I suggested that we walk into the office and speak with someone about the concierge services. Kim exclaimed incredulously, "You mean unannounced without an appointment?" I responded, "Exactly. I can't think of a better way of getting a sense of the level of customer service."
We explained to the friendly receptionist who greeted us why we were there. With that, she immediately introduced us to a friendly medical assistant, who asked if we'd like to meet with the doctor. Taken aback, we stammered a yes. She ushered us into his private office, said he'd be with us shortly after finishing with a patient, offered us water, and gave us a brochure to read.
The doctor's office was clean, neat and nicely decorated but not ostentatiously so. Memorabilia and pictures on the desk and walls indicated that the doctor was an avid cyclist.
When he walked in, our first impressions of him matched the surroundings. He was tall, handsome, and fit. More importantly, he was very personable, had good eye contact, was a good listener, and was very patient and thorough in explaining how his practice was different and what we would get for the annual concierge fee, which is $1,800 for an individual or $3,200 for a couple. He explained that one major difference between his practice and the typical practice is that he has about 400 patients, or about one-fifth the average patient load in Tucson.
When he excused himself to take a call, Kim and I gave each other a thumbs-up. We had planned to do some traveling during our golden years but agreed that spending $3,200 on a concierge fee instead of a trip was money well spent. Not only that, but the fee was a fraction of what the average American spends on car payments, car insurance, and car repairs. (Yet Americans whine about medical costs but not auto costs.)
We told the doctor when he returned that we wanted to sign up. He said great, asked his assistant to help with the paperwork, and graciously said that we could use his desk.
Unfortunately, this arrangement will be short-lived. As millennials gain political power, they will put an end to the "unfairness" of some people getting more personalized medical care than others, since, as surveys show, millennials are predominately socialist.
Oh, well, when that happens, Kim and I will have to drive down the road to Mexico for personalized medical care, assuming that Trump doesn't first end such unfair trade with Mexico.