Mark McClusky says for elite athletes today, pushing boundaries and breaking records is all about "the aggregation of marginal gains."
A recent survey of physicians by the consulting firm Accenture found that one in three independent doctors is thinking about no longer accepting health insurance and going into what’s been called concierge care, where they cap the number of patients they see, and patients –who pay them as much as $30,000 a year– get to see the doctor whenever they want.
But Bloomberg Businessweek reports that a new trend is emerging: low-cost concierge care, such as Atlas MD, a family practice in Wichita, Kansas, which charges most of its adult patients just $50 dollars a month for unlimited visits, free medical tests, house calls… you even get the doctor’s cell phone number.
“It makes it very nice,” says co-founder Dr. Doug Nunamaker, “because now I don’t have to bill and code and satisfy an insurance company for reimbursement.”
Atlas MD, according to Dr. Nunamaker, has two physicians and one nurse. A neighboring clinic in Witchita has six physicians and 62 employees. Dr. Nunamaker does limit his patient load to 500-600 people, and critics say doctors who do that can select the healthiest patients to keep costs down.
“All of that,” says Dr. Nunamaker when talking about high employee-to-physician clinics, “is to help move patients through, it’s a patient factory. So you have people to sign patients in, to take them back to the room, to take them back out, the administrative staff, the billers and coders.”
Nunamaker says his tiny staff of three people share a lot of the day-to-day responsibilities: from answering the phones to taking vitals to wiping down the counters. Nunamaker says he’s able to pass these savings on to patients.
Health Insurance As Car Insurance?
But Dr. Nunamaker says most of his patients have insurance, but about 30 percent of their patients are uninsured and otherwise would struggle to see a doctor. He says people should start thinking about health insurance like car insurance, where the patient pays the doctor for “routine maintenance.”
“Your car insurance pays for a car wreck,” says Nunamaker. “It does not pay for gas, or oil, or tires or car washes. But we’re expecting health insurance to pay for surgeries, and cancers, and heart attacks, and medicines, and office visits –all of those things. Well of courses it’s expensive.”
Dr. Nunamaker advises his patients to switch to a high deductible plan. This saves his patients money every month when they come to him for “the sniffles” and broken arms, but they’re covered in case of a serious illness or accident.